Data_Sheet_1_Stationary Atrial Fibrillation Properties in the Goat Do Not Entail Stable or Recurrent Conduction Patterns.ZIP

Introduction: Electro-anatomical mapping of the atria is used to identify the substrate of atrial fibrillation (AF). Targeting this substrate by ablation in addition to pulmonary vein ablation did not consistently improve outcome in clinical trials. Generally, the assessment of the substrate is based on short recordings (≤10 s, often even shorter). Thus, targeting the AF substrate assumes spatiotemporal stationarity but little is known about the variability of electrophysiological properties of AF over time.Methods: Atrial fibrillation (AF) was maintained for 3–4 weeks after pericardial electrode implantation in 12 goats. Within a single AF episode 10 consecutive minutes were mapped on the left atrial free wall using a 249-electrode array (2.25 mm inter-electrode spacing). AF cycle length, fractionation index (FI), lateral dissociation, conduction velocity, breakthroughs, and preferentiality of conduction (Pref) were assessed per electrode and AF property maps were constructed. The Pearson correlation coefficient (PCC) between the 10 AF-property maps was calculated to quantify the degree spatiotemporal stationarity of AF properties. Furthermore, the number of waves and presence of re-entrant circuits were analyzed in the first 60-s file. Comparing conduction patterns over time identified recurrent patterns of AF with the use of recurrence plots.Results: The averages of AF property maps were highly stable throughout the ten 60-s-recordings. Spatiotemporal stationarity was high for all 6 property maps, PCC ranged from 0.66 ± 0.11 for Pref to 0.98 ± 0.01 for FI. High stationarity was lost when AF was interrupted for about 1 h. However, the time delay between the recorded files within one episode did not affect PCC. Yet, multiple waves (7.7 ± 2.3) were present simultaneously within the recording area and during 9.2 ± 11% of the analyzed period a re-entrant circuit was observed. Recurrent patterns occurred rarely and were observed in only 3 out of 12 goats.Conclusions: During non-self-terminating AF in the goat, AF properties were stationary. Since this could not be attributed to stable recurrent conduction patterns during AF, it is suggested that AF properties are determined by anatomical and structural properties of the atria even when the conduction patterns are very variable.

引言：心房电解剖学映射技术被用于识别房颤（AF）的基质。在临床试验中，通过消融该基质（除肺静脉消融外）并未能持续改善预后。通常，基质的评估基于短暂的记录（≤10秒，通常更短）。因此，针对房颤基质的治疗假设了时空稳定性，但对于房颤电生理特性随时间变化的变异性知之甚少。
方法：在12只山羊的心包电极植入后维持房颤3-4周。在单个房颤发作期间，使用249电极阵列（电极间距离2.25毫米）在左心房自由壁上对连续10分钟的电活动进行映射。对每个电极和房颤特性进行了房颤周期长度、分数指数（FI）、侧向分离、传导速度、突破和传导优先性（Pref）的评估，并构建了房颤特性地图。计算了10个房颤特性地图之间的皮尔逊相关系数（PCC），以量化房颤特性时空稳定性的程度。此外，对前60秒文件中的波形数量和是否存在折返环路进行了分析。通过比较随时间变化的传导模式，利用重演图识别了房颤的反复模式。
结果：在十次60秒记录中，房颤特性地图的平均值高度稳定。所有6个特性地图的时空稳定性均较高，PCC值从Pref的0.66 ± 0.11到FI的0.98 ± 0.01不等。当房颤中断约1小时后，高稳定性丧失。然而，记录文件之间的时间延迟并未影响PCC。然而，在记录区域内同时存在多个波形（7.7 ± 2.3），并且在分析期间9.2 ± 11%的时间段内观察到折返环路。反复模式很少发生，仅在12只山羊中的3只中观察到。
结论：在山羊的非自终止性房颤期间，房颤特性保持稳定。由于这不能归因于房颤期间的稳定反复传导模式，因此建议，即使传导模式非常多变，房颤特性也由心房的解剖和结构特性决定。