title: Noninvasive Estimation of Epicardial Dominant High-Frequency Regions During Atrial Fibrillation.
abstract: BACKGROUND
  Ablation of high dominant frequency (DF) sources in patients with atrial fibrillation (AF) is an effective treatment option for paroxysmal AF. The aim of this study was to evaluate the accuracy of noninvasive estimation of DF and electrical patterns determination by solving the inverse problem of the electrocardiography.
  
  
  METHODS
  Four representative AF patients with left-to-right and right-to-left atrial DF patterns were included in the study. For each patient, intracardiac electrograms from both atria were recorded simultaneously together with 67-lead body surface recordings. In addition to clinical recordings, realistic mathematical models of atria and torso anatomy with different DF patterns of AF were used. For both mathematical models and clinical recordings, inverse-computed electrograms were compared to intracardiac electrograms in terms of voltage, phase, and frequency spectrum relative errors.
  
  
  RESULTS
  Comparison between intracardiac and inverse computed electrograms for AF patients showed 8.8 ± 4.4% errors for DF, 32 ± 4% for voltage, and 65 ± 4% for phase determination. These results were corroborated by mathematical simulations showing that the inverse problem solution was able to reconstruct the frequency spectrum and the DF maps with relative errors of 5.5 ± 4.1%, whereas the reconstruction of the electrograms or the instantaneous phase presented larger relative errors (i.e., 38 ± 15% and 48 ± 14 % respectively, P < 0.01).
  
  
  CONCLUSIONS
  Noninvasive reconstruction of atrial frequency maps can be achieved by solving the inverse problem of electrocardiography with a higher accuracy than temporal distribution patterns.
authors.affiliation: ITACA, Universitat Politècnica de València, Valencia, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Pedrón-Torrecilla
authors.affiliation: ITACA, Universitat Politècnica de València, Valencia, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Rodrigo
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain and Facultad de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Andreu M
authors.initials: AM
authors.lastname: Climent
authors.affiliation: ITACA, Universitat Politècnica de València, Valencia, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Liberos
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain and Facultad de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Pérez-David
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain and Facultad de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Bermejo
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain and Facultad de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Arenal
authors.affiliation: ITACA, Universitat Politècnica de València, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Millet
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain and Facultad de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Avilés
authors.affiliation: Facultad de Medicina, Universidad Complutense de Madrid, Spain Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, U.S.A.
authors.forename: Omer
authors.initials: O
authors.lastname: Berenfeld
authors.affiliation: Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain and Facultad de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Atienza
authors.affiliation: ITACA, Universitat Politècnica de València, Valencia, Spain.
authors.forename: María S
authors.initials: MS
authors.lastname: Guillem
mesh_terms: D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology*; D018780:Body Surface Potential Mapping / Q000379:methods*; D003198:Computer Simulation; D056149:Epicardial Mapping / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D010496:Pericardium / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: atrial fibrillation; body surface potential mapping; dominant frequency; inverse problem; noninvasive mapping