Right atrial organization and wavefront analysis in atrial fibrillation

The purpose of this study was to develop techniques to quantify the propagation pattern of the electrical activation during atrial fibrillation (AF) along a one-dimensional catheter. Taking intra-atrial signal organization aspects into account, the atrial activations are detected and combined into wavefronts. Parameters describing wavefront consistency and activation order along the catheter are defined, and the relationship of wavefront consistency to body surface parameters, namely AF frequency and exponential decay, is investigated. The database consisted of 26 10-s recordings from patients during drug-refractory AF, in which five adjacent bipolar electrograms from a catheter in the right atrium were recorded. The 12-lead ECG was recorded simultaneously. The degree of wavefront consistency provided insights into the temporal variability of the activation order, an aspect which was not reflected by the body surface parameters. However, AF frequency was able to distinguish between recordings with different degrees of intra-atrial signal organization (p = 0.008).