Atrial Fibrillation (AF) is the most prevalent sustained arrhythmia, yet current ablation therapies, including pulmonary vein isolation, are frequently ineffective in persistent AF due to the involvement of non-pulmonary vein drivers. This study proposes a deep learning framework using convolutional autoencoders for unsupervised feature extraction from unipolar and bipolar intracavitary electrograms (EGMs) recorded during AF in ablation studies. These latent representations of atrial electrical activity enable the characterization and automation of EGM analysis, facilitating the detection of AF drivers. The database consisted of 11,404 acquisitions recorded from 291 patients, containing 228,080 unipolar EGMs and 171,060 bipolar EGMs. The au-toencoders successfully learned latent representations with low reconstruction loss, preserving the morphological features. The extracted embeddings allowed downstream classifiers to detect rotational and focal activity with moderate performance (AUC 0.73-0.76) This work highlights the potential of unsupervised learning to uncover physiologically meaningful features from intracardiac signals. Introduction Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, affecting an estimated 59 million people around the world in 2019 [1]. It is defined as a supraventricular tachyarrhythmia characterized by disorganized electrical activity of the atrium and ineffective atrial contraction [2]. As life expectancy increases worldwide, the prevalence of AF is expected to rise accordingly [3]. Although some patients may be asymptomatic, many experience symptoms such as palpitations, fatigue, and dyspnea.

Atrial Fibrillation (AF) is characterized by disorganised electrical activity in the atria and is known to be sustained by the presence of regions of fibrosis (scars) or functional cellular remodeling, both of which may lead to areas of slow conduction. Estimating the effective conductivity of the myocardium and identifying regions of abnormal propagation is therefore crucial for the effective treatment of AF. We hypothesise that the spatial distribution of tissue conductivity can be directly inferred from an array of concurrently acquired contact electrograms (EGMs). We generate a dataset of simulated cardiac AP propagation using randomised scar distributions and a phenomenological cardiac model and calculate contact EGMs at various positions on the field. EGMs are enriched with noise extracted from biological data acquired in the lab. A deep neural network, based on a modified U-net architecture, is trained to estimate the location of the scar and quantify conductivity of the tissue with a Jaccard index of 91%. We adapt a wavelet-based surrogate testing analysis to confirm that the inferred conductivity distribution is an accurate representation of the ground truth input to the model. We find that the root mean square error (RMSE) between the ground truth and our predictions is significantly smaller ($p_{val}<0.01$) than the RMSE between the ground truth and surrogate samples.

MARSEILLE, France and PROVIDENCE, R.I., April 27, 2022 (GLOBE NEWSWIRE) -- Volta Medical, a pioneering medtech startup advancing novel artificial intelligence (AI) algorithms to treat cardiac arrhythmias, today announced it will participate at Heart Rhythm 2022, where Volta VX1 digital AI companion technology will be featured in several venues, including a poster session, podium presentation, Rhythm Theater program and the Volta exhibit booth. VX1 is a machine and deep learning-based algorithm designed to assist operators in the real-time manual annotation of 3D anatomical and electrical maps of the human atria during atrial fibrillation (AF) or atrial tachycardia. It is the first FDA cleared AI-based tool in interventional cardiac electrophysiology (EP). On Friday, April 29, VX1 will be highlighted in two scientific sessions: session DH-202, "Machine Learning Applications for Arrhythmia Detection and Treatment" from 10:30-11:30 a.m. Volta's Rhythm Theater presentation, "Can AI Solve the Persistent AF Paradigm?," will be held Saturday, April 30 from 10:00-11:00 a.m.

We review some of the latest approaches to analysing cardiac electrophysiology data using machine learning and predictive modelling. Cardiac arrhythmias, particularly atrial fibrillation, are a major global healthcare challenge. Treatment is often through catheter ablation, which involves the targeted localized destruction of regions of the myocardium responsible for initiating or perpetuating the arrhythmia. Ablation targets are either anatomically defined, or identified based on their functional properties as determined through the analysis of contact intracardiac electrograms acquired with increasing spatial density by modern electroanatomic mapping systems. While numerous quantitative approaches have been investigated over the past decades for identifying these critical curative sites, few have provided a reliable and reproducible advance in success rates. Machine learning techniques, including recent deep-learning approaches, offer a potential route to gaining new insight from this wealth of highly complex spatio-temporal information that existing methods struggle to analyse. Coupled with predictive modelling, these techniques offer exciting opportunities to advance the field and produce more accurate diagnoses and robust personalised treatment. We outline some of these methods and illustrate their use in making predictions from the contact electrogram and augmenting predictive modelling tools, both by more rapidly predicting future states of the system and by inferring the parameters of these models from experimental observations.

This technical note considers the problems of blind sparse learning and inference of electrogram (EGM) signals under atrial fibrillation (AF) conditions. First of all we introduce a mathematical model for the observed signals that takes into account the multiple foci typically appearing inside the heart during AF. Then we propose a reconstruction model based on a fixed dictionary and discuss several alternatives for choosing the dictionary. In order to obtain a sparse solution that takes into account the biological restrictions of the problem, a first alternative is using LASSO regularization followed by a post-processing stage that removes low amplitude coefficients violating the refractory period characteristic of cardiac cells. As an alternative we propose a novel regularization term, called cross products LASSO (CP-LASSO), that is able to incorporate the biological constraints directly into the optimization problem. Unfortunately, the resulting problem is non-convex, but we show how it can be solved efficiently in an approximated way making use of successive convex approximations (SCA). Finally, spectral analysis is performed on the clean activation sequence obtained from the sparse learning stage in order to estimate the number of latent foci and their frequencies. Simulations on synthetic and real data are provided to validate the proposed approach.