title: The relationship among complex fractionated electrograms, wavebreak, phase singularity, and local dominant frequency in fibrillation wave-dynamics: a modeling comparison study.
abstract: Although complex fractionated electrogram (CFE) is known to be a target for catheter ablation of fibrillation, its physiological meaning in fibrillation wave-dynamics remains to be clarified. We evaluated the spatiotemporal relationships among the parameters of fibrillation wave-dynamics by simulation modeling. We generated maps of CFE-cycle length (CFE-CL), local dominant frequency (LDF), wave break (WB), and phase singularity (PS) of fibrillation in 2-dimensional homogeneous bidomain cardiac modeling (1,000 × 1,000 cells ten Tusscher model). We compared spatiotemporal correlations by dichotomizing each maps into 10 × 10 lattice zones. In spatial distribution, WB and PS showed excellent correlation (R = 0.963, P < 0.001). CFE-CL had weak correlations with WB (R = 0.288, P < 0.001), PS (R = 0.313, P < 0.001), and LDF (R = -0.411, P < 0.001). However, LDF did not show correlation with PS or WB. PSs were mostly distributed at the periphery of low CFE-CL area. Virtual ablation (5% of critical mass) of CFE-CL < 100 ms terminated fibrillation at 14.3 sec, and high LDF ablation (5% of critical mass) changed fibrillation to organized tachycardia, respectively. In homogeneous 2D fibrillation modeling, CFE-CL was weakly correlated with WB, PS, and LDF, spatiotemporally. PSs are mostly positioned at the periphery of low CFE-CL areas, and virtual ablation targeting low CFE-CL regions terminated fibrillation successfully.
authors.affiliation: Department of Convergence Biomedical Engineering, Daelim University College, Anyang, Korea.
authors.forename: Yonghyeon
authors.identifier: 0000-0001-5497-452X
authors.initials: Y
authors.lastname: Yun
authors.affiliation: Division of Cardiology, Yonsei University Health System, Seoul, Korea.
authors.forename: Minki
authors.identifier: 0000-0001-7404-3052
authors.initials: M
authors.lastname: Hwang
authors.affiliation: Division of Cardiology, Yonsei University Health System, Seoul, Korea.
authors.forename: Jae Hyung
authors.identifier: 0000-0002-3198-1134
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Biomedical Engineering, Chonnam National University, Yeosu, Korea.
authors.forename: Hangsik
authors.identifier: 0000-0002-3353-0310
authors.initials: H
authors.lastname: Shin
authors.affiliation: Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, Korea.
authors.forename: Eun Bo
authors.identifier: 0000-0003-2657-0389
authors.initials: EB
authors.lastname: Shim
authors.affiliation: Division of Cardiology, Yonsei University Health System, Seoul, Korea.
authors.forename: Hui-Nam
authors.identifier: 0000-0002-3256-3620
authors.initials: HN
authors.lastname: Pak
mesh_terms: D000465:Algorithms; D001281:Atrial Fibrillation / Q000503:physiopathology*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation; D004562:Electrocardiography; D004566:Electrodes; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D008954:Models, Biological
keywords: Complex Fractionated Electrogram; Fibrillation; Simulation Modeling