relation: http://publicatio.bibl.u-szeged.hu/35709/
title: AF-FLOW Global Registry Confirms Validity of Electrographic Flow Mapping as a Phenotyping Tool for Atrial Fibrillation
creator:  Nilsson Kent R.
creator:  Castellano Steven
creator:  Kong Melissa H.
creator:  Derejko Pawel
creator:  Szili-Török Tamás
creator:  Goyal Sandeep K.
creator:  Wijchers Sip
creator:  Turagam Mohit
creator:  Reddy Vivek Y.
creator:  Verma Atul
creator:  Kollaborációs szervezet: AF‐FLOW Global Registry Study Group
creator:  Ahapov Kostiantyn
creator:  Bardyszewski Alexander
creator:  Kuśnierz Jacek
creator:  Dzwonkowska Dobromila
creator:  Hoogendijk Mark
subject: 03.02. Klinikai orvostan
description: Electrographic flow (EGF) mapping allows for the visualization of global atrial wavefront propagations. One mechanism of initiation and maintenance of atrial fibrillation (AF) is stimulation from EGF-identified focal sources that serve as driver sites of fibrillatory conduction. Electrographic flow consistency (EGFC) further quantifies the concordance of observed wavefront patterns, indicating that a healthier substrate shows more organized wavefront propagation and higher EGFC. Freedom from AF (FFAF) recurrence has accordingly been shown to be higher in patients with ablated vs. unablated sources and with high vs. low EGFC.(1) Measure FFAF across EGF-derived phenotypes in patients enrolled in the AF-FLOW Global Registry; (2) determine if a relationship exists between EGFC and percentage of healthy voltage as measured from bipolar voltage maps.The AF-FLOW Global Registry is a multicenter, prospective study of 25 all-comer AF patients who underwent concomitant high-density bipolar voltage mapping with a 16-electrode grid mapping catheter and EGF mapping with a 64-pole basket catheter. The EGF algorithm detects extra-pulmonary vein sources as origins of excitation from a singularity of divergent flow vectors and was used to localize RF ablation targets. Overall, EGFC per atrium was also computed as the average of the modulus of individual EGF vectors, where the vector length represents the consistency of flow patterns. Patients were then assigned phenotypes on the basis of source presence or absence and EGFC, and rates of FFAF at 1-year were compared across the four resulting phenotypes. Atrial EGFC was also compared to the percentage of healthy tissue determined by bipolar voltage mapping.Patients with paroxysmal AF had higher FFAF than persistent AF (PeAF) and long-standing PeAF patients; patients receiving de novo ablation had higher FFAF than those receiving redo ablation. Patient phenotyping revealed that those with high EGFC had higher FFAF than those with low EGFC (p = 0.015). Atrial EGFC was also correlated to the percent of high voltage tissue across all patients (r = 0.651, p < 0.0001).EGF mapping provides insights into the mechanistic nature of AF and the atrial health of the underlying substrate. Therefore, further studies are needed to develop phenotype-specific treatments for the disease.ClinicalTrials.gov identifier: NCT05481359.
date: 2025
type: Folyóiratcikk
type: PeerReviewed
format: text
identifier: http://publicatio.bibl.u-szeged.hu/35709/7/35701450.pdf
format: text
identifier: http://publicatio.bibl.u-szeged.hu/35709/1/Nilson.pdf
identifier:     Nilsson Kent R.;  Castellano Steven;  Kong Melissa H.;  Derejko Pawel;  Szili-Török Tamás;  Goyal Sandeep K.;  Wijchers Sip;  Turagam Mohit;  Reddy Vivek Y.;  Verma Atul;  Kollaborációs szervezet: AF‐FLOW Global Registry Study Group;  Ahapov Kostiantyn;  Bardyszewski Alexander;  Kuśnierz Jacek;  Dzwonkowska Dobromila;  Hoogendijk Mark: AF-FLOW Global Registry Confirms Validity of Electrographic Flow Mapping as a Phenotyping Tool for Atrial Fibrillation.   JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 36 (3).  pp. 589-599.  ISSN 1045-3873 (2025)     
identifier: doi:10.1111/jce.16568
relation: https://doi.org/10.1111/jce.16568
relation: 35701450
language: eng
relation: info:eu-repo/semantics/altIdentifier/doi/10.1111/jce.16568
rights: info:eu-repo/semantics/openAccess