An experienced cardiologist, Sanjiv M. Narayan, MD, PhD, delivers research results as head of Stanford University’s Atrial Fibrillation Program. His background extends to a past role as electrophysiology co-director with the University of California, San Diego, and director of electrophysiology and arrhythmia services with the Veterans Affairs Medical Center in San Diego. Dr. Sanjiv Narayan has a strong interest in emerging digital pathways of mapping atrial fibrillation (AF).

Characterized by an irregular and often extremely rapid heartbeat, AF can cause blood clots in the heart and increase stroke risk. A 2022 article in the Arrythmia and Electrophysiology Review, “Future Directions for Mapping Atrial Fibrillation” examines digital strategies beyond traditional anatomically based pulmonary vein isolation (PVI), which has success rates in the 55 to 75 percent range.

There are a number of AF mapping methods, including electrographic flow (EGF) mapping, which involves the application of panoramic basket catheter recordings. These record voltage shapes from atrial sources, and use an optical flow algorithm in computing average flow behavior. Vector summation is applied and an electroanatomic map is generated that distinguishes active and passive sites, where targeted ablation is used to eliminate atrial fibrillation. (Ablation involves the application of small burns or freezes that break up the electrical signals responsible for irregular heartbeats.)

Other methods examined in the paper include stochastic trajectory analysis of tanked signals (STAR), which employs imported electrogram signals, and the CARTOFINDER electroanatomic mapping system.