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Atrial fibrosis is typically identified 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 fibrosis. A simulated 2D tissue with a fibrosis patch was used for validation. We computed EIGDR maps from both original and time-aligned u-EGMs, denoted as<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\mathcal {R}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:mi>R<\/mml:mi><\/mml:math><\/jats:alternatives><\/jats:inline-formula>and<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\mathcal{R}^{\\mathcal{A}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msup><mml:mrow><mml:mi>R<\/mml:mi><\/mml:mrow><mml:mi>A<\/mml:mi><\/mml:msup><\/mml:math><\/jats:alternatives><\/jats:inline-formula>, respectively, also mapping the gain in eigenvalue concentration obtained by the alignment,<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\Delta \\mathcal{R}^{\\mathcal{A}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:mrow><mml:mi>\u0394<\/mml:mi><mml:msup><mml:mrow><mml:mi>R<\/mml:mi><\/mml:mrow><mml:mi>A<\/mml:mi><\/mml:msup><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula>. The performance of each map in detecting fibrosis was evaluated in scenarios including noise and variable electrode-tissue distance. Best results were achieved by<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\mathcal{R}^{\\mathcal{A}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msup><mml:mrow><mml:mi>R<\/mml:mi><\/mml:mrow><mml:mi>A<\/mml:mi><\/mml:msup><\/mml:math><\/jats:alternatives><\/jats:inline-formula>, reaching 94% detection accuracy, versus the 86% of b-EGMs voltage maps. The proposed strategy was also tested in real u-EGMs from fibrotic and non-fibrotic areas over 3D electroanatomical maps, supporting the ability of the EIGDRs as fibrosis markers, encouraging further studies to confirm their translation to clinical settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Graphical Abstract<\/jats:title><jats:p>Upper panels: map of<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\mathcal {R}^{\\mathcal {A}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msup><mml:mrow><mml:mi>R<\/mml:mi><\/mml:mrow><mml:mi>A<\/mml:mi><\/mml:msup><\/mml:math><\/jats:alternatives><\/jats:inline-formula>from 3\u00d73 cliques for \u03a8=\u20090<jats:sup>\u2218<\/jats:sup>and bipolar voltage map<jats:italic>V<\/jats:italic><jats:sup><jats:italic>b<\/jats:italic>-<jats:italic>m<\/jats:italic><\/jats:sup>, performed assuming a variable electrode-to-tissue distance and noisy u-EGMs (noise level<jats:italic>\u03c3<\/jats:italic><jats:sub><jats:italic>v<\/jats:italic><\/jats:sub>=\u200946.4<jats:italic>\u03bc<\/jats:italic><jats:italic>V<\/jats:italic>). Lower panels: detected fibrotic areas (brown), using the thresholds that maximize detection accuracy of each map<\/jats:p><\/jats:sec>","DOI":"10.1007\/s11517-022-02648-3","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T06:04:56Z","timestamp":1663049096000},"page":"3091-3112","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Atrial fibrosis identification with unipolar electrogram eigenvalue distribution analysis in multi-electrode arrays"],"prefix":"10.1007","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6264-4229","authenticated-orcid":false,"given":"Jennifer","family":"Riccio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Alcaine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Rocher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Martinez-Mateu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Saiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Invers-Rubio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria S.","family":"Guillem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Laguna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"issue":"4","key":"2648_CR1","first-page":"233","volume":"14","author":"P Platonov","year":"2017","unstructured":"Platonov P (2017) Atrial fibrosis: an obligatory component of arrhythmia mechanisms in atrial fibrillation? 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Europace 23(3):380\u2013388. https:\/\/doi.org\/10.1093\/europace\/euaa313","journal-title":"Europace"}],"container-title":["Medical &amp; Biological Engineering &amp; Computing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11517-022-02648-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11517-022-02648-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11517-022-02648-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T21:59:51Z","timestamp":1676757591000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11517-022-02648-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,13]]},"references-count":43,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["2648"],"URL":"https:\/\/doi.org\/10.1007\/s11517-022-02648-3","relation":{},"ISSN":["0140-0118","1741-0444"],"issn-type":[{"value":"0140-0118","type":"print"},{"value":"1741-0444","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,13]]},"assertion":[{"value":"31 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The clinical data were collected from a patient undergoing AF ablation, who also got a late gadolinium enhancement-magnetic resonance imaging acquisition prior to the ablation procedure. The data acquisition protocol was reviewed and approved by the Hospital Clinic Ethical Committee (Ethics approval number: HCB\/2019\/0881). The patient was informed and signed the consent form.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}}]}}