Bipolar electrogram Shannon entropy at sites of rotational activation implications for ablation of atrial fibrillation

Anand N. Ganesan, Pawel Kuklik, Dennis H. Lau, Anthony G. Brooks, Mathias Baumert, Wei Wen Lim, Shivshankar Thanigaimani, Sachin Nayyar, Rajiv Mahajan, Jonathan M. Kalman, Kurt C. Roberts-Thomson, Prashanthan Sanders

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Background - The pivot is critical to rotors postulated to maintain atrial fibrillation (AF). We reasoned that wavefronts circling the pivot should broaden the amplitude distribution of bipolar electrograms because of directional information encoded in these signals. We aimed to determine whether Shannon entropy (ShEn), a measure of signal amplitude distribution, could differentiate the pivot from surrounding peripheral regions and thereby assist clinical rotor mapping. Methods and Results - Bipolar electrogram recordings were studied in 4 systems: (1) computer simulations of rotors in a 2-dimensional atrial sheet; (2) isolated rat atria recorded with a multi-electrode array (n=12); (3) epicardial plaque recordings of induced AF in hypertensive sheep (n=11); and (4) persistent AF patients (n=10). In the model systems, rotation episodes were identified, and ShEn calculated as an index of amplitude distribution. In humans, ShEn distribution was analyzed at AF termination sites and with respect to complex fractionated electrogram mean. We analyzed rotation episodes in simulations (4 cycles) and animals (rats: 14 rotors, duration 80±81 cycles; sheep: 13 rotors, 4.2±1.5 cycles). The maximum ShEn bipole was consistently colocated with the pivot zone. ShEn was negatively associated with distance from the pivot zone in simulated spiral waves, rats, and sheep. ShEn was modestly inversely associated with complex fractionated electrogram; however, there was no relationship at the sites of highest ShEn. Conclusions - ShEn is a mechanistically based tool that may assist AF rotor mapping.

LanguageEnglish
Pages48-57
Number of pages10
JournalCirculation: Arrhythmia and Electrophysiology
Volume6
Issue number1
DOIs
Publication statusPublished - 1 Feb 2013

Keywords

  • Arrhythmia
  • Atrial fibrillation
  • Electrophysiology
  • Mapping

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Ganesan, Anand N. ; Kuklik, Pawel ; Lau, Dennis H. ; Brooks, Anthony G. ; Baumert, Mathias ; Lim, Wei Wen ; Thanigaimani, Shivshankar ; Nayyar, Sachin ; Mahajan, Rajiv ; Kalman, Jonathan M. ; Roberts-Thomson, Kurt C. ; Sanders, Prashanthan. / Bipolar electrogram Shannon entropy at sites of rotational activation implications for ablation of atrial fibrillation. In: Circulation: Arrhythmia and Electrophysiology. 2013 ; Vol. 6, No. 1. pp. 48-57.
@article{6ad737ad67c344aa933ce4d42a909821,
title = "Bipolar electrogram Shannon entropy at sites of rotational activation implications for ablation of atrial fibrillation",
abstract = "Background - The pivot is critical to rotors postulated to maintain atrial fibrillation (AF). We reasoned that wavefronts circling the pivot should broaden the amplitude distribution of bipolar electrograms because of directional information encoded in these signals. We aimed to determine whether Shannon entropy (ShEn), a measure of signal amplitude distribution, could differentiate the pivot from surrounding peripheral regions and thereby assist clinical rotor mapping. Methods and Results - Bipolar electrogram recordings were studied in 4 systems: (1) computer simulations of rotors in a 2-dimensional atrial sheet; (2) isolated rat atria recorded with a multi-electrode array (n=12); (3) epicardial plaque recordings of induced AF in hypertensive sheep (n=11); and (4) persistent AF patients (n=10). In the model systems, rotation episodes were identified, and ShEn calculated as an index of amplitude distribution. In humans, ShEn distribution was analyzed at AF termination sites and with respect to complex fractionated electrogram mean. We analyzed rotation episodes in simulations (4 cycles) and animals (rats: 14 rotors, duration 80±81 cycles; sheep: 13 rotors, 4.2±1.5 cycles). The maximum ShEn bipole was consistently colocated with the pivot zone. ShEn was negatively associated with distance from the pivot zone in simulated spiral waves, rats, and sheep. ShEn was modestly inversely associated with complex fractionated electrogram; however, there was no relationship at the sites of highest ShEn. Conclusions - ShEn is a mechanistically based tool that may assist AF rotor mapping.",
keywords = "Arrhythmia, Atrial fibrillation, Electrophysiology, Mapping",
author = "Ganesan, {Anand N.} and Pawel Kuklik and Lau, {Dennis H.} and Brooks, {Anthony G.} and Mathias Baumert and Lim, {Wei Wen} and Shivshankar Thanigaimani and Sachin Nayyar and Rajiv Mahajan and Kalman, {Jonathan M.} and Roberts-Thomson, {Kurt C.} and Prashanthan Sanders",
year = "2013",
month = "2",
day = "1",
doi = "10.1161/CIRCEP.112.976654",
language = "English",
volume = "6",
pages = "48--57",
journal = "Circulation: Arrhythmia and Electrophysiology",
issn = "1941-3149",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

Ganesan, AN, Kuklik, P, Lau, DH, Brooks, AG, Baumert, M, Lim, WW, Thanigaimani, S, Nayyar, S, Mahajan, R, Kalman, JM, Roberts-Thomson, KC & Sanders, P 2013, 'Bipolar electrogram Shannon entropy at sites of rotational activation implications for ablation of atrial fibrillation', Circulation: Arrhythmia and Electrophysiology, vol. 6, no. 1, pp. 48-57. https://doi.org/10.1161/CIRCEP.112.976654

Bipolar electrogram Shannon entropy at sites of rotational activation implications for ablation of atrial fibrillation. / Ganesan, Anand N.; Kuklik, Pawel; Lau, Dennis H.; Brooks, Anthony G.; Baumert, Mathias; Lim, Wei Wen; Thanigaimani, Shivshankar; Nayyar, Sachin; Mahajan, Rajiv; Kalman, Jonathan M.; Roberts-Thomson, Kurt C.; Sanders, Prashanthan.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 6, No. 1, 01.02.2013, p. 48-57.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Bipolar electrogram Shannon entropy at sites of rotational activation implications for ablation of atrial fibrillation

AU - Ganesan, Anand N.

AU - Kuklik, Pawel

AU - Lau, Dennis H.

AU - Brooks, Anthony G.

AU - Baumert, Mathias

AU - Lim, Wei Wen

AU - Thanigaimani, Shivshankar

AU - Nayyar, Sachin

AU - Mahajan, Rajiv

AU - Kalman, Jonathan M.

AU - Roberts-Thomson, Kurt C.

AU - Sanders, Prashanthan

PY - 2013/2/1

Y1 - 2013/2/1

N2 - Background - The pivot is critical to rotors postulated to maintain atrial fibrillation (AF). We reasoned that wavefronts circling the pivot should broaden the amplitude distribution of bipolar electrograms because of directional information encoded in these signals. We aimed to determine whether Shannon entropy (ShEn), a measure of signal amplitude distribution, could differentiate the pivot from surrounding peripheral regions and thereby assist clinical rotor mapping. Methods and Results - Bipolar electrogram recordings were studied in 4 systems: (1) computer simulations of rotors in a 2-dimensional atrial sheet; (2) isolated rat atria recorded with a multi-electrode array (n=12); (3) epicardial plaque recordings of induced AF in hypertensive sheep (n=11); and (4) persistent AF patients (n=10). In the model systems, rotation episodes were identified, and ShEn calculated as an index of amplitude distribution. In humans, ShEn distribution was analyzed at AF termination sites and with respect to complex fractionated electrogram mean. We analyzed rotation episodes in simulations (4 cycles) and animals (rats: 14 rotors, duration 80±81 cycles; sheep: 13 rotors, 4.2±1.5 cycles). The maximum ShEn bipole was consistently colocated with the pivot zone. ShEn was negatively associated with distance from the pivot zone in simulated spiral waves, rats, and sheep. ShEn was modestly inversely associated with complex fractionated electrogram; however, there was no relationship at the sites of highest ShEn. Conclusions - ShEn is a mechanistically based tool that may assist AF rotor mapping.

AB - Background - The pivot is critical to rotors postulated to maintain atrial fibrillation (AF). We reasoned that wavefronts circling the pivot should broaden the amplitude distribution of bipolar electrograms because of directional information encoded in these signals. We aimed to determine whether Shannon entropy (ShEn), a measure of signal amplitude distribution, could differentiate the pivot from surrounding peripheral regions and thereby assist clinical rotor mapping. Methods and Results - Bipolar electrogram recordings were studied in 4 systems: (1) computer simulations of rotors in a 2-dimensional atrial sheet; (2) isolated rat atria recorded with a multi-electrode array (n=12); (3) epicardial plaque recordings of induced AF in hypertensive sheep (n=11); and (4) persistent AF patients (n=10). In the model systems, rotation episodes were identified, and ShEn calculated as an index of amplitude distribution. In humans, ShEn distribution was analyzed at AF termination sites and with respect to complex fractionated electrogram mean. We analyzed rotation episodes in simulations (4 cycles) and animals (rats: 14 rotors, duration 80±81 cycles; sheep: 13 rotors, 4.2±1.5 cycles). The maximum ShEn bipole was consistently colocated with the pivot zone. ShEn was negatively associated with distance from the pivot zone in simulated spiral waves, rats, and sheep. ShEn was modestly inversely associated with complex fractionated electrogram; however, there was no relationship at the sites of highest ShEn. Conclusions - ShEn is a mechanistically based tool that may assist AF rotor mapping.

KW - Arrhythmia

KW - Atrial fibrillation

KW - Electrophysiology

KW - Mapping

UR - http://www.scopus.com/inward/record.url?scp=84876341565&partnerID=8YFLogxK

U2 - 10.1161/CIRCEP.112.976654

DO - 10.1161/CIRCEP.112.976654

M3 - Article

VL - 6

SP - 48

EP - 57

JO - Circulation: Arrhythmia and Electrophysiology

T2 - Circulation: Arrhythmia and Electrophysiology

JF - Circulation: Arrhythmia and Electrophysiology

SN - 1941-3149

IS - 1

ER -