Electrographic Flow Mapping for Persistent Atrial Fibrillation:
Theoretical Basis and Preliminary Observations
Abstract
Ablation strategies remain poorly defined for persistent atrial
fibrillation (AF) patients with recurrence despite intact pulmonary vein
isolation (PVI). As the ability to perform durable PVI improves, the
need for advanced mapping to identify extra-PV sources of AF becomes
increasingly evident. Multiple mapping technologies attempt to localize
these self-sustained triggers and/or drivers responsible for initiating
and/or maintaining AF; however, current approaches suffer from technical
limitations. Electrographic flow (EGF) mapping is a novel mapping method
based on well-established principles of optical flow and fluid dynamics.
It enables the full spatiotemporal reconstruction of organized wavefront
propagation within the otherwise chaotic and disorganized electrical
conduction of AF. Given the novelty of EGF mapping and relative
unfamiliarity of most clinical electrophysiologists with the
mathematical principles powering the EGF algorithm, this paper provides
an in-depth explanation of the technical/mathematical foundations of EGF
mapping and demonstrates clinical applications of EGF mapping data and
analyses.