Ozgul, O., Marques, V. G., Hermans, B. J., van Hunnik, A., Verheule, S., Gharaviri, A., Pezzuto, S., Auricchio, A., Schotten, U., Bonizzi, P., & Zeemering, S. (2025). High-Density and High-Coverage Composite Atrial Activation Maps: An In-Silico Validation Study. IEEE Transactions on Biomedical Engineering, 72(1), 79-89. https://doi.org/10.1109/TBME.2024.3439502

@article{6bc8020ed911493698a09e6f777db6a7,
title = "High-Density and High-Coverage Composite Atrial Activation Maps: An In-Silico Validation Study",
abstract = "OBJECTIVE: Repetitive atrial activation patterns (RAAPs) during complex atrial tachycardia could be associated with localized mechanisms that can be targeted. Clinically available electroanatomical mapping systems are limited by either the spatial coverage or electrode density of the mapping catheters, preventing the adequate visualization of transiently occurring RAAPs. This work proposes a technique to overcome this shortcoming by stitching spatially overlapping conduction patterns together to a larger image- called a composite map.METHODS: Simulated stable mechanisms and meandering reentries are sequentially mapped (4 × 4 grid, 3 mm spacing) and then reconstructed back to the original sizes with the proposed recurrence plot-based algorithm.RESULTS: The reconstruction of single linear waves presents minimal errors (local activation time (LAT) difference: 3.2 [1.6-4.9] ms, conduction direction difference: 5.2 [2.3-8.0] degrees). Errors significantly increase (p<0.05) for more complex patterns, being the highest with unstable reentries (LAT difference: 10.3 [3.5-16.2] ms, conduction direction difference: 18.2 [6.7-29.7] deg). In a second part of the analysis, 111 meandering reentries are reconstructed. Mapping 30 locations overlappingly around each reentry core was found to be the optimal mapping strategy. For this optimal setting, LAT, conduction direction, and core localization errors are low (6.1 [4.2-8.6] ms, 11.2 [8.6-15.5] deg and 4.1 [2.9-4.9] mm, respectively) and are weakly correlated with the degree of the meander ( = 0.41, = 0.40 and = 0.20, respectively).CONCLUSION: Our findings underline the feasibility of generating composite maps by stitching spatially overlapping recordings.SIGNIFICANCE: Composite maps can be instrumental in personalized ablation strategies.",
keywords = "Humans, Computer Simulation, Heart Atria/physiopathology, Models, Cardiovascular, Algorithms, Body Surface Potential Mapping/methods, Heart Conduction System/physiology, Reproducibility of Results",
author = "Ozan Ozgul and Marques, {Victor G} and Hermans, {Ben Jm} and {van Hunnik}, Arne and Sander Verheule and Ali Gharaviri and Simone Pezzuto and Angelo Auricchio and Ulrich Schotten and Pietro Bonizzi and Stef Zeemering",
note = "Funding Information: This work was supported in part by the European Union under (PersonalizeAF) Grant 860974 and (MAESTRIA) Grant 965286, in part by the Swiss National Supercomputing Centre under Project s1074, and in part by the Dutch Heart Foundation under (EmbRACE) Grant 01-002-2022-0118. Funding Information: This work is part of PersonalizeAF project. The project received funding from the European Union\u2019s Horizon 2020 research and innovation programme under the Marie Sk\u0142odowska-Curie grant agreements No 860974. This work was also supported by the Swiss National Supercomputing Centre (CSCS), project s1074, by the MAESTRIA project (Horizon 2020 grant agreement No 965286), and by the Dutch Heart Foundation project 01-002-2022-0118, EmbRACE (Electro-Molecular Basis and the theRapeutic management of Atrial Cardiomyopathy, fibrillation and associated outcomEs). Publisher Copyright: {\textcopyright} 2024 The Authors.",
year = "2025",
month = jan,
doi = "10.1109/TBME.2024.3439502",
language = "English",
volume = "72",
pages = "79--89",
journal = "IEEE Transactions on Biomedical Engineering",
issn = "0018-9294",
publisher = "IEEE Computer Society",
number = "1",
}