Novel Multiscale Frequency Approach to Identify the Pivot Point of the Rotor¹

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a prognostic marker for stroke, heart failure, and even death [1]. There is now a general consensus that rotors, i.e., stable electrical sources of cardiac excitation, can cause AF [2]. The pivot points (or cores) of the rotors are believed to be good ablation targets to terminate AF in patients. About 77.8% success rate was demonstrated by ablation of such sites with the CONFIRM trial in paroxysmal, persistent, and long-standing AF patients [3]. Current mapping methods used for guiding catheter ablation such as local activation time map, complex fractionated atrial electrograms mean index map, dominant frequency (DF), phase singularity, and wave block analysis provide information about the spatiotemporal organization of AF, however, they suffer numerous limitations to accurately identify the rotor pivot points due to various noises, misleading phase, and activation times...