title: Electrophysiological Rotor Ablation in In-Silico Modeling of Atrial Fibrillation: Comparisons with Dominant Frequency, Shannon Entropy, and Phase Singularity.
abstract: BACKGROUND
  Although rotors have been considered among the drivers of atrial fibrillation (AF), the rotor definition is inconsistent. We evaluated the nature of rotors in 2D and 3D in- silico models of persistent AF (PeAF) by analyzing phase singularity (PS), dominant frequency (DF), Shannon entropy (ShEn), and complex fractionated atrial electrogram cycle length (CFAE-CL) and their ablation.
  
  
  METHODS
  Mother rotor was spatiotemporally defined as stationary reentries with a meandering tip remaining within half the wavelength and lasting longer than 5 s. We generated 2D- and 3D-maps of the PS, DF, ShEn, and CFAE-CL during AF. The spatial correlations and ablation outcomes targeting each parameter were analyzed.
  
  
  RESULTS
  1. In the 2D PeAF model, we observed a mother rotor that matched relatively well with DF (>9 Hz, 71.0%, p<0.001), ShEn (upper 2.5%, 33.2%, p<0.001), and CFAE-CL (lower 2.5%, 23.7%, p<0.001). 2. The 3D-PeAF model also showed mother rotors that had spatial correlations with DF (>5.5 Hz, 39.7%, p<0.001), ShEn (upper 8.5%, 15.1%, p <0.001), and CFAE (lower 8.5%, 8.0%, p = 0.002). 3. In both the 2D and 3D models, virtual ablation targeting the upper 5% of the DF terminated AF within 20 s, but not the ablations based on long-lasting PS, high ShEn area, or lower CFAE-CL area.
  
  
  CONCLUSIONS
  Mother rotors were observed in both 2D and 3D human AF models. Rotor locations were well represented by DF, and their virtual ablation altered wave dynamics and terminated AF.
authors.affiliation: Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Minki
authors.initials: M
authors.lastname: Hwang
authors.affiliation: Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Jun-Seop
authors.initials: JS
authors.lastname: Song
authors.affiliation: Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Young-Seon
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Changyong
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, Kangwon-do, Republic of Korea.
authors.forename: Eun Bo
authors.initials: EB
authors.lastname: Shim
authors.affiliation: Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology*; D003198:Computer Simulation; D006801:Humans; D008955:Models, Cardiovascular