Determination of Synchronization of Electrical Activity in the Heart by Shannon Entropy Measure

In this paper we propose a new index of synchronization for the study of heart’s electrical activity during atrial fibrillation (AF). The index relies on the measure of the time delays between correspondent activations in two atrial electrograms and on the characterization of their dispersion by a measure of Shannon Entropy. The algorithm was validated on simulated signals mimicking different degree of synchronization. Results showed the index was able to discriminate among different levels of organization, provided that it works on series of at least 50 activations (time resolution of almost 10 sec during AF). Moreover, we applied the algorithm to real bipolar electrograms, obtained from a…

Quantification of synchronization during atrial fibrillation by Shannon entropy: Validation in patients and computer model of atrial arrhythmias

Atrial fibrillation (AF), a cardiac arrhythmia classically described as completely desynchronized, is now known to show a certain amount of synchronized electrical activity. In the present work a new method for quantifying the level of synchronization of the electrical activity recorded in pairs of atrial sites during atrial fibrillation is presented. A synchronization index (Sy) was defined by quantifying the degree of complexity of the distribution of the time delays between sites by Shannon entropy estimation. The capability of Sy to discriminate different AF types in patients was assessed on a database of 60 pairs of endocardial recordings from a multipolar basket catheter. The analysis…

A Novel Approach to Propagation Pattern Analysis in Intracardiac Atrial Fibrillation Signals

The purpose of this study is to investigate propagation patterns in intracardiac signals recorded during atrial fibrillation (AF) using an approach based on partial directed coherence (PDC), which evaluates directional coupling between multiple signals in the frequency domain. The PDC is evaluated at the dominant frequency of AF signals and tested for significance using a surrogate data procedure specifically designed to assess causality. For significantly coupled sites, the approach allows also to estimate the delay in propagation. The methods potential is illustrated with two simulation scenarios based on a detailed ionic model of the human atrial myocyte as well as with real data recordi…

A stochastic approach for automatic registration and fusion of left atrial electroanatomic maps with 3D CT anatomical images.

The integration of electroanatomic maps with highly resolved computed tomography cardiac images plays an important role in the successful planning of the ablation procedure of arrhythmias. In this paper, we present and validate a fully-automated strategy for the registration and fusion of sparse, atrial endocardial electroanatomic maps (CARTO maps) with detailed left atrial (LA) anatomical reconstructions segmented from a pre-procedural MDCT scan. Registration is accomplished by a parameterized geometric transformation of the CARTO points and by a stochastic search of the best parameter set which minimizes the misalignment between transformed CARTO points and the LA surface. The subsequent …

An integrated approach based on uniform quantization for the evaluation of complexity of short-term heart period variability: Application to 24 h Holter recordings in healthy and heart failure humans.

We propose an integrated approach based on uniform quantization over a small number of levels for the evaluation and characterization of complexity of a process. This approach integrates information-domain analysis based on entropy rate, local nonlinear prediction, and pattern classification based on symbolic analysis. Normalized and non-normalized indexes quantifying complexity over short data sequences (∼300 samples) are derived. This approach provides a rule for deciding the optimal length of the patterns that may be worth considering and some suggestions about possible strategies to group patterns into a smaller number of families. The approach is applied to 24 h Holter recordings of …

Deterioration of organization in the first minutes of atrial fibrillation: A beat-to-beat analysis of cycle length and wave similarity

Deterioration of AF Organization. Introduction: It has been recently suggested that many episodes of atrial fibrillation (AF) may be partially organized at the onset and thus more suitable for antitachycardia pacing therapy. Nevertheless, the time course of organization in the first minutes of AF has not been quantified yet. Methods and Results: Twenty episodes of paroxysmal AF were studied. Electrograms were recorded from the right atrium (RA), distal (CSd), and proximal coronary sinus (CSp). The time course of AF cycle length (AFCL) and the regularity of wave morphology (similarity index S) were beat-to-beat measured at each recording site during the first 7 minutes of AF. AFCL and S show…

Feasibility of cuff-free measurement of systolic and diastolic arterial blood pressure

We validated a prototype cuff-free device for noninvasive estimation of blood pressure (BP). The system assumed a linear relation between BP values and the inverse of arterial blood pulse transit time, measured as time interval between the R wave on the electrocardiograph and the onset of the peripheral pulse wave on a finger plethysmogram. Thirty-three healthy subjects were analyzed at rest and during increasing stress exercise. To estimate subject-specific linear model parameters, the system was calibrated ad personam with reference to BP measures obtained by a cuff sphygmomanometer. High correlation values (R2= 0.89 and 0.78 for systolic and diastolic BP, respectively) and differences co…

A Multi-Variate Predictability Framework to Assess Invasive Cardiac Activity and Interactions during Atrial Fibrillation

Objective: This study introduces a predictability framework based on the concept of Granger causality (GC), in order to analyze the activity and interactions between different intracardiac sites during atrial fibrillation (AF). Methods: GC-based interactions were studied using a three-electrode analysis scheme with multi-variate autoregressive models of the involved preprocessed intracardiac signals. The method was evaluated in different scenarios covering simulations of complex atrial activity as well as endocardial signals acquired from patients. Results: The results illustrate the ability of the method to determine atrial rhythm complexity and to track and map propagation during AF. Conc…

Measuring postural-related changes of spontaneous baroreflex sensitivity after repeated long-duration diving: Frequency domain approaches

Sustained water immersion is thought to modulate orthostatic tolerance to an extent dependent on the duration and repetition over consecutive days of the diving sessions. We tested this hypothesis investigating in ten healthy subjects the potential changes in the cardiovascular response to head-up tilt induced by single and multiple resting air dives. Parametric cross-spectral analysis of spontaneous RR interval and systolic arterial pressure variability was performed in three experimental sessions: before diving (BD), after single 6-hour dive (ASD), and after multiple 6-hour dives (AMD, 5 consecutive days with 18-hour surface interval). From this analysis, baroreflex sensitivity (BRS) was …

Letter by Masè et al Regarding Article, "Granger Causality-Based Analysis for Classification of Fibrillation Mechanisms and Localization of Rotational Drivers".

Quantitative assessment of synchronization during atrial fibrillation by Shannon Entropy characterization of propagation delays

This study introduced a new method for the quantification of the synchronization (S) and the causal verse of activation (S12) in couples of atrial electrograms recorded during atrial fibrillation (AF). The synchronization indexes S and S12 relied on the measure of the propagation delays between coupled activation times in two atrial signals and on the characterization of their dispersion by Shannon-Entropy (SE). S and S12 were validated both on simulated activation time series and endocavitary signals in patients. In simulation, S and S12 were equal to 1 for propagation of one single wavefront in a fully excitable tissue, while they decreased for reentries in partially excitable tissue (S =…