Electrophysiological heterogeneity of atrial fibrillation and local effect of propafenone in the human right atrium: analysis based on symbolic dynamics.
A recently developed algorithm that is based on symbolic dynamics and computation of the normalized algorithmic complexity (C(alpha)) was applied to basket-catheter mapping of the atrial fibrillation (AF). The aim of our study was to analyze the spatial distribution of the C(alpha) during AF and effects of propafenone on this distribution. During right atrial mapping in 25 patients with AF 31 intra-atrial and 1 surface bipolar channels were acquired. The anatomical location of the intra-atrial electrodes was defined fluoroscopically. C(alpha) was calculated for a moving window (size: 2000 points; step 500 points). Generated C(alpha) was analyzed within 10 minutes before and after administration of propafenone. The inter-regional C(alpha) distribution was analyzed using the Friedman-test (intra-individually) and Kruskall-Wallis-H-test (inter- individually). A value of p=0.05 was set for an error probability. Inter-regional C(alpha) differences were found in all patients (p<0.001). The right atrium could be divided in high- and low complexity areas according to individual patterns. A significant C(alpha) increase in cranio-caudal direction (with the exception of septum) was confirmed inter-individually (p<0.01). The administration of propafenone enlarged the areas of low complexity.


CONCLUSIONS
This new method utilizing the combination of symbolic dynamics and adaptive power estimation can provide complex evaluation of the dynamics of AF in man. High-density mapping will be required for further evaluation of results.
Dept. of Cardiology, Kerckhoff Clinic, Bad Nauheim, Germany. Alexander.Berkowitsch@kerchhoff.med.uni-giessen.de
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Berkowitsch
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Carlsson
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Erdogan
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Neuzner
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Pitschner
D000465:Algorithms; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology*; D001281:Atrial Fibrillation / Q000503:physiopathology*; D018780:Body Surface Potential Mapping; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011405:Propafenone / Q000494:pharmacology*
D000889:Anti-Arrhythmia Agents; D011405:Propafenone