doi:10.1007/s11517-022-02648-3engRiccio, JenniferAlcaine, AlejandroRocher, SaraMartinez-Mateu, LauraSaiz, JavierInvers-Rubio, EricGuillem, Maria S.Martínez, Juan PabloLaguna, PabloAtrial fibrosis identification with unipolar electrogram eigenvalue distribution analysis in multi-electrode arraysART-2022-131379Atrial fbrosis plays a key role in the initiation and progression of atrial fbrillation (AF). Atrial fbrosis is typically identifed by a peak-to-peak amplitude of bipolar electrograms (b-EGMs) lower than 0.5 mV, which may be considered as ablation targets. Nevertheless, this approach disregards signal spatiotemporal information and b-EGM sensitivity to catheter orientation. To overcome these limitations, we propose the dominant-to-remaining eigenvalue dominance ratio (EIGDR) of unipolar electrograms (u-EGMs) within neighbor electrode cliques as a waveform dispersion measure, hypothesizing that it is correlated with the presence of fbrosis. A simulated 2D tissue with a fbrosis patch was used for validation. We computed EIGDR maps from both original and time-aligned u-EGMs, denoted as R and RA, respectively, also mapping the gain in eigenvalue concentration obtained by the alignment, ΔRA. The performance of each map in detecting fbrosis was evaluated in scenarios including noise and variable electrode-tissue distance. Best results were achieved by RA, reaching 94% detection accuracy, versus the 86% of b-EGMs voltage maps. The proposed strategy was also tested in real u-EGMs from fbrotic and non-fbrotic areas over 3D electroanatomical maps, supporting the ability of the EIGDRs as fbrosis markers, encouraging further studies to confrm their translation to clinical settings.2022http://zaguan.unizar.es/record/12094610.1007/s11517-022-02648-3http://zaguan.unizar.es/record/120946oai:zaguan.unizar.es:120946info:eu-repo/grantAgreement/ES/DGA-FEDER/Construyendo Europa desde Aragóninfo:eu-repo/grantAgreement/ES/DGA-FSE/T39-20R-BSICoS groupinfo:eu-repo/grantAgreement/EC/H2020/766082/EU/MultidisciplinarY training network for ATrial fibRillation monItoring, treAtment and progression/MY-ATRIAThis project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 766082-MY-ATRIAinfo:eu-repo/grantAgreement/EC/H2020/860974/EU/Personalized Therapies for Atrial Fibrillation. A Translational Approach/PersonalizeAFThis project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 860974-PersonalizeAFinfo:eu-repo/grantAgreement/ES/MICINN/PID2019-104881RB-I00info:eu-repo/grantAgreement/ES/MICINN/PID2019-105674RB-I00MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING 60, 11 (2022), 3091-3112byhttp://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccess