An Automated Algorithm for Determining Conduction Velocity, Wavefront Direction and Origin of Focal Cardiac Arrhythmias Using a Multipolar Catheter

Roney, Caroline ;   Cantwell, Chris ;   Qureshi, Norman ;   Ali, Rheeda ;   Chang, Eugene ;   Lim, Phang Boon ;   Sherwin, Spencer ;   Peters, Nicholas ;   Siggers, Jennifer ;   Ng, Fu Siong

Determining locations of focal arrhythmia sources and quantifying myocardial conduction velocity (CV) are two major challenges in clinical catheter ablation cases. CV, wavefront direction and focal source location can be estimated from multipolar catheter data, but currently available methods are time-consuming, limited to specific electrode configurations, and can be inaccurate. We developed automated algorithms to rapidly identify CV from multipolar catheter data with any arrangement of electrodes, whilst providing estimates of wavefront direction and focal source position, which can guide the catheter towards a focal arrhythmic source. We validated our methods using simulations on realistic human left atrial geometry. We subsequently applied them to clinically-acquired intracardiac electrogram data, where CV and wavefront direction were accurately determined in all cases, whilst focal source locations were correctly identified in 2/3 cases. Our novel automated algorithms can potentially be used to guide ablation of focal arrhythmias in real-time in cardiac catheter laboratories.