Critical appraisal of technologies to assess electrical activity during atrial fibrillation: a position paper from the European Heart Rhythm Association and European Society of Cardiology Working Group on eCardiology in collaboration with the Heart Rhythm Society, Asia Pacific Heart Rhythm Society, Latin American Heart Rhythm Society and Computing in Cardiology
Issued Date
2022-02-01
Resource Type
ISSN
10995129
eISSN
15322092
Scopus ID
2-s2.0-85124437328
Pubmed ID
34878119
Journal Title
Europace
Volume
24
Issue
2
Start Page
313
End Page
330
Rights Holder(s)
SCOPUS
Bibliographic Citation
Europace Vol.24 No.2 (2022) , 313-330
Suggested Citation
De Groot N.M.S. Critical appraisal of technologies to assess electrical activity during atrial fibrillation: a position paper from the European Heart Rhythm Association and European Society of Cardiology Working Group on eCardiology in collaboration with the Heart Rhythm Society, Asia Pacific Heart Rhythm Society, Latin American Heart Rhythm Society and Computing in Cardiology. Europace Vol.24 No.2 (2022) , 313-330. 330. doi:10.1093/europace/euab254 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86149
Title
Critical appraisal of technologies to assess electrical activity during atrial fibrillation: a position paper from the European Heart Rhythm Association and European Society of Cardiology Working Group on eCardiology in collaboration with the Heart Rhythm Society, Asia Pacific Heart Rhythm Society, Latin American Heart Rhythm Society and Computing in Cardiology
Author(s)
Author's Affiliation
Institutionen för Kliniska Vetenskaper, Lund
Hospital De San José, Bogotá, Colombia
Karlsruher Institut für Technologie
Korea University Medicine
CARIM School for Cardiovascular Disease
Gruppo Ospedaliero San Donato
Onze Lieve Vrouw Hospital
Hôpital Erasme
School of Medicine
Erasmus MC
Columbia University
Charité – Universitätsmedizin Berlin
Danderyds Sjukhus
Herzzentrum Leipzig
Cleveland Clinic Foundation
Karolinska Universitetssjukhuset
Edinburgh Napier University
Universidad de Zaragoza
Hospital Israelita Albert Einstein
Faculty of Medicine Ramathibodi Hospital, Mahidol University
University of Washington
Hôpitaux Universitaires de Genève
Deutsches Herzzentrum München
Maastricht Universitair Medisch Centrum+
Delft University of Technology
Medisch Spectrum Twente (MST)
Mayo Clinic
St Bartholomew's Hospital
Tokyo Medical and Dental University
College of Medical, Veterinary & Life Sciences
Emory University
Mayo Medical School
Campus Bad Neustadt
Cardiovascular Institute of Buenos Aires
Hospital De San José, Bogotá, Colombia
Karlsruher Institut für Technologie
Korea University Medicine
CARIM School for Cardiovascular Disease
Gruppo Ospedaliero San Donato
Onze Lieve Vrouw Hospital
Hôpital Erasme
School of Medicine
Erasmus MC
Columbia University
Charité – Universitätsmedizin Berlin
Danderyds Sjukhus
Herzzentrum Leipzig
Cleveland Clinic Foundation
Karolinska Universitetssjukhuset
Edinburgh Napier University
Universidad de Zaragoza
Hospital Israelita Albert Einstein
Faculty of Medicine Ramathibodi Hospital, Mahidol University
University of Washington
Hôpitaux Universitaires de Genève
Deutsches Herzzentrum München
Maastricht Universitair Medisch Centrum+
Delft University of Technology
Medisch Spectrum Twente (MST)
Mayo Clinic
St Bartholomew's Hospital
Tokyo Medical and Dental University
College of Medical, Veterinary & Life Sciences
Emory University
Mayo Medical School
Campus Bad Neustadt
Cardiovascular Institute of Buenos Aires
Other Contributor(s)
Abstract
We aim to provide a critical appraisal of basic concepts underlying signal recording and processing technologies applied for (i) atrial fibrillation (AF) mapping to unravel AF mechanisms and/or identifying target sites for AF therapy and (ii) AF detection, to optimize usage of technologies, stimulate research aimed at closing knowledge gaps, and developing ideal AF recording and processing technologies. Recording and processing techniques for assessment of electrical activity during AF essential for diagnosis and guiding ablative therapy including body surface electrocardiograms (ECG) and endo- or epicardial electrograms (EGM) are evaluated. Discussion of (i) differences in uni-, bi-, and multi-polar (omnipolar/Laplacian) recording modes, (ii) impact of recording technologies on EGM morphology, (iii) global or local mapping using various types of EGM involving signal processing techniques including isochronal-, voltage- fractionation-, dipole density-, and rotor mapping, enabling derivation of parameters like atrial rate, entropy, conduction velocity/direction, (iv) value of epicardial and optical mapping, (v) AF detection by cardiac implantable electronic devices containing various detection algorithms applicable to stored EGMs, (vi) contribution of machine learning (ML) to further improvement of signals processing technologies. Recording and processing of EGM (or ECG) are the cornerstones of (body surface) mapping of AF. Currently available AF recording and processing technologies are mainly restricted to specific applications or have technological limitations. Improvements in AF mapping by obtaining highest fidelity source signals (e.g. catheter-electrode combinations) for signal processing (e.g. filtering, digitization, and noise elimination) is of utmost importance. Novel acquisition instruments (multi-polar catheters combined with improved physical modelling and ML techniques) will enable enhanced and automated interpretation of EGM recordings in the near future.