Award Details

Grant ID
Project Title
Atrial Fibrillation Mapping Using Phase-Aligned Spectral Filtering for Decomposing Spatiotemporal Dynamics
Award Amount
200000.0000
Primary Organization
Cleveland Clinic Foundation
Award Start Date - Award End Date
07/01/2023 - 06/30/2025
Program Name
Innovative Project Award
PI and PI Equivalents
Larisa Tereshchenko (PI) - Cleveland Clinic Foundation ORCID logo  https://orcid.org/0000-0002-6976-1313
Prior PI
Summary

Atrial fibrillation (AF) ablation is an important treatment strategy, potentially capable of curing AF. However, there is a variable degree of success of the persistent AF ablation procedure. Therefore, it is necessary to improve the success rate of persistent AF ablation. To improve the success rate of persistent AF ablation, I propose a novel analytical approach to AF mapping. Analysis of intracardiac electrograms (EGMs) is the key component of AF mapping. In the past, several approaches to atrial EGM analysis have been developed, aiming to help guide AF ablation beyond pulmonary vein isolation (PVI). However, none (except PVI) have been established to guide the AF catheter ablation procedure. The most widely used approach for AF ablation is an empiric, anatomic AF ablation approach (PVI). Previously tested (and ultimately failed) methods included complex fractionated atrial electrogram (CFAÉ), dominant frequency (DF) mapping, activation (FIRM) mapping, and fibrosis-detected-by-CMR-mapping AF ablation. A novel solution to the known AF mapping problem is necessary to improve AF ablation outcomes. Successful completion of the proposed project will improve the success rate of persistent AF ablation, which is crucially necessary for further progress in the cardiac electrophysiology field. I proposed a novel analytical approach. I will apply phase-aligned spectral filtering to AF atrial EGMs mapping data to identify spatially structured dynamic components and thus identify AF ablation targets. Spectral filtering is an efficient dimension reduction for high-dimensional time series, which has not been applied to AF mapping data analysis. My approach assumes that the observed spatiotemporal data (AF EGMs mapping data) represent superimposed lower-rank smooth oscillations and movements from a dynamic generative system (AF ablation target) mixed with higher-rank random noises. Separating the signals from noises is essential for us to locate and understand these lower-rank dynamic systems. It could be that such a lower-rank dynamic system has multiple independent components corresponding to different trends or functionalities of the system. I propose a novel framework for identifying lower-rank dynamics and their components embedded in a high-dimensional spatiotemporal system (AF EGMs map). It is based on a known statistical approach of structural decomposition and phase-aligned construction in the frequency domain., which has not been applied to AF EGM analysis.