Analysis of Atrial Fibrillation Dynamics in Body Surface Potential Maps and Electrocardiographic Imaging

Previous studies have shown that global short- (ST) and long-term (LT) atrial fibrillation (AF) dynamics can be characterized non-invasively by Body Surface Potentials (BSPM). Also, Electrocardiographic Imaging (ECGI) may add information as it can characterize locally the atrial substrate. The objective of this study is to compare AF dynamics characterized on both BSPM and ECGI signals. Two consecutive 4-second BSPM signals from 34 AF patients (23 male, 8 paroxysmal, 63.1 ± 9.5 years) were recorded, followed by ECGI computation. ST and LT dynamics metrics were computed in both BSPM and ECGI, assessed from a multivariate autocorrelation of the signals. BSPM features of ST dynamics positively correlated with LT dynamics (0.52 and 0.78). Analogous values of correlation were obtained in ECGI. When normalized by the LT dynamics, the ST inversely correlated with the speed of propagation of AF at half AF cycle (BSPM, r = -0.28 vs. ECGI, r = -0.45), showing higher stability in the ST propagation for faster AF. BSPM and ECGI reflected similar relationships in the analysis of AF propagation dynamics. Results were consistent with previous studies and suggest that BSPM are sufficient to characterize global AF dynamics, while ECGI may become relevant when more localized information is required.