Electrocardiographic Imaging for Atrial Fibrillation: A Perspective From Computer Models and Animal Experiments to Clinical Value

Roderic Mòbil

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Electrocardiographic Imaging for Atrial Fibrillation: A Perspective From Computer Models and Animal Experiments to Clinical Value

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dc.contributor.author Salinet, João
dc.contributor.author Molero, Rubén
dc.contributor.author Schlindwein, Fernando S.
dc.contributor.author Karel, Joël
dc.contributor.author Rodrigo Bort, Miguel
dc.contributor.author Rojo-Álvarez, José Luis
dc.contributor.author Berenfeld, Omer
dc.contributor.author Climent, Andreu M.
dc.contributor.author Zenger, Brian
dc.contributor.author Vanheusden, Frederique
dc.contributor.author Siles Paredes, Jimena Gabriela
dc.contributor.author MacLeod, Rob
dc.contributor.author Atienza, Felipe
dc.contributor.author Guillem, María S.
dc.contributor.author Cluitmans, Matthijs
dc.contributor.author Bonizzi, Pietro
dc.date.accessioned 2022-05-13T14:17:36Z
dc.date.available 2022-05-13T14:17:36Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/10550/82768
dc.description.abstract Electrocardiographic imaging (ECGI) is a technique to reconstruct non-invasively the electrical activity on the heart surface from body-surface potential recordings and geometric information of the torso and the heart. ECGI has shown scientific and clinical value when used to characterize and treat both atrial and ventricular arrhythmias. Regarding atrial fibrillation (AF), the characterization of the electrical propagation and the underlying substrate favoring AF is inherently more challenging than for ventricular arrhythmias, due to the progressive and heterogeneous nature of the disease and its manifestation, the small volume and wall thickness of the atria, and the relatively large role of microstructural abnormalities in AF. At the same time, ECGI has the advantage over other mapping technologies of allowing a global characterization of atrial electrical activity at every atrial beat and non-invasively. However, since ECGI is time-consuming and costly and the use of electrical mapping to guide AF ablation is still not fully established, the clinical value of ECGI for AF is still under assessment. Nonetheless, AF is known to be the manifestation of a complex interaction between electrical and structural abnormalities and therefore, true electro-anatomical-structural imaging may elucidate important key factors of AF development, progression, and treatment. Therefore, it is paramount to identify which clinical questions could be successfully addressed by ECGI when it comes to AF characterization and treatment, and which questions may be beyond its technical limitations. In this manuscript we review the questions that researchers have tried to address on the use of ECGI for AF characterization and treatment guidance (for example, localization of AF triggers and sustaining mechanisms), and we discuss the technological requirements and validation. We address experimental and clinical results, limitations, and future challenges for fruitful application of ECGI for AF understanding and management. We pay attention to existing techniques and clinical application, to computer models and (animal or human) experiments, to challenges of methodological and clinical validation. The overall objective of the study is to provide a consensus on valuable directions that ECGI research may take to provide future improvements in AF characterization and treatment guidance.
dc.language.iso eng
dc.relation.ispartof Frontiers In Physiology, 2021, vol. 12, num. 653013
dc.rights.uri info:eu-repo/semantics/openAccess
dc.source Salinet, João Molero, Rubén Schlindwein, Fernando S. Karel, Joël Rodrigo Bort, Miguel Rojo-Álvarez, José Luis Berenfeld, Omer Climent, Andreu M. Zenger, Brian Vanheusden, Frederique Siles Paredes, Jimena Gabriela MacLeod, Rob Atienza, Felipe Guillem, María S. Cluitmans, Matthijs Bonizzi, Pietro 2021 Electrocardiographic Imaging for Atrial Fibrillation: A Perspective From Computer Models and Animal Experiments to Clinical Value Frontiers In Physiology 12 653013
dc.subject Imatges tridimensionals en medicina
dc.subject Sistema cardiovascular
dc.subject Enginyeria biomèdica
dc.title Electrocardiographic Imaging for Atrial Fibrillation: A Perspective From Computer Models and Animal Experiments to Clinical Value
dc.type info:eu-repo/semantics/article
dc.date.updated 2022-05-13T14:17:36Z
dc.identifier.doi https://doi.org/10.3389/fphys.2021.653013
dc.identifier.idgrec 152894


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Roderic Mòbil