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Computers in Cardiology, 2004

DOI: 10.1109/cic.2004.1442921

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

Proceedings article published in 2004 by M. Masè, F. Ravelli, L. Faes ORCID, R. Antolini, G. Nollo
This paper is available in a repository.
This paper is available in a repository.

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Abstract

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 = 0.70 ± 0.05, S12 - 0.66 ± 0.05) and multiple wavelet propagation (S = 0.46 ± 0.06, S12 = 0.39 ± 0.08). In patients S, was equal to 1 during atrial flutter (AFl) and decreased with increasing complexity of AF (AF1: S = 0.76 ± 0.05; AF2: S = 0.56 ± 0.06; AF3: S = 0.39 ± 0.03). Moreover S12 evidenced the preservation of a correct activation sequence during AFl and AF1 (S12 = S) and its loss during AF2 (S12 = 0.41 ± 0.12 < S) and AF3 (S12 = 0.26 ± 0.03 < S). As indirect markers of the electrophysiological properties of atrial tissue, indexes S and S12 may provide a new insight in understanding the mechanisms initiating and maintaining AF and support new clinical treatments for its interruption.