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Current Directions in Biomedical Engineering

Joint Journal of the German Society for Biomedical Engineering in VDE and the Austrian and Swiss Societies for Biomedical Engineering

Editor-in-Chief: Dössel, Olaf

Editorial Board: Augat, Peter / Buzug, Thorsten M. / Haueisen, Jens / Jockenhoevel, Stefan / Knaup-Gregori, Petra / Kraft, Marc / Lenarz, Thomas / Leonhardt, Steffen / Malberg, Hagen / Penzel, Thomas / Plank, Gernot / Radermacher, Klaus M. / Schkommodau, Erik / Stieglitz, Thomas / Urban, Gerald A.


CiteScore 2018: 0.47

Source Normalized Impact per Paper (SNIP) 2018: 0.377

Open Access
Online
ISSN
2364-5504
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Estimating refractory periods during atrial fibrillation based on electrogram cycle lengths in a heterogeneous simulation setup

Laura Unger
  • Corresponding author
  • Institute of Biomedical Engineering, Karlsruhe Institute of Technology, Fritz-Haber-Weg 1, 76131 Karlsruhe, Germany
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  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Tobias Oesterlein
  • Institute of Biomedical Engineering, University of Vermont - College of Medicine, United States of America
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  • De Gruyter OnlineGoogle Scholar
/ Gunnar Seemann
  • Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen & Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany
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  • De Gruyter OnlineGoogle Scholar
/ Olaf Dössel
  • Institute of Biomedical Engineering, University of Vermont - College of Medicine, United States of America
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/ Peter Spector / Axel Loewe
  • Institute of Biomedical Engineering, University of Vermont - College of Medicine, United States of America
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-09-07 | DOI: https://doi.org/10.1515/cdbme-2017-0181

Abstract

Acquiring adequate mapping data in patients with atrial fibrillation is still one of the main obstacles in the treatment of this atrial arrhythmia. Due to the lack of catheters with both a panoramic field of view and sufficient electrode density for simultaneous mapping, electrophysiologists are forced to fall back on sequential mapping techniques. But, because activation patterns change rapidly during atrial fibrillation, they cannot be mapped sequentially. We propose that mapping tissue properties which are time independent, in contrast, allows a sequential approach. Here, we use the shortest measured electrogram cycle length to estimate the effective refractory period of the underlying tissue in a simulation study. Atrial fibrillation was simulated in a spherical model of the left atrium comprised of regions with varied refractory period. We found that the minimal measured electrogram cycle length correlates with the effective refractory period of the underlying tissue if the regions with distinct refractory properties are large enough and if the absolute difference in effective refractory periods is sufficient. This approach is capable of identifying regions of lowered effective refractory period without the need for cardioversion. Those regions are likely to harbor drivers of atrial fibrillation, which emphasizes the necessity of their localization.

Keywords: cardiac modeling; atrial fibrillation; substrate mapping; effective refractory period; heterogeneity

About the article

Published Online: 2017-09-07


Citation Information: Current Directions in Biomedical Engineering, Volume 3, Issue 2, Pages 317–320, ISSN (Online) 2364-5504, DOI: https://doi.org/10.1515/cdbme-2017-0181.

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©2017 Laura Unger et al., published by De Gruyter.. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License. BY-NC-ND 4.0

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Frontiers in Physiology, 2019, Volume 9

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