PO-01-195 PHENOTYPING PERSISTENT AF WITH ELECTROGRAPHIC FLOW MAPPING

There is broad consensus that differentiating AF into the categories of “paroxysmal AF” vs “persistent (PerAF)” “LS-PerAF” a relatively crude means to differentiate types. Clearly, there pressing need for better strategies phenotype AF. Electrographic Flow (EGF) mapping designed identify not only active sources excitation, but also estimate consistency observed atrial wavefront propagation. flow (EGFC) computed from Euclidean length vector field estimates over time and may provide additional insight an individual patient’s fibrillation (AF) disease in combination with EGF-identified enable phenotyping PerAF patients. To 1) determine relationship between EGFC recurrence, 2) propose framework treatment prognosis based on functional mechanisms as described by EGF. In randomized FLOW-AF trial, patients prospectively underwent PVI subsequent EGF-guided source ablation all cases when such were identified, PVI-only no seen. each patient, series 1-min EGF recordings taken multiple locations per atrium post-PVI pre- any adjunctive or ablation. Mean these averaged basket position averages overall across locations. A decision tree classifier was employed optimal splitting point below which scores more commonly associated recurrence within 12 months. Per FLOW-AF’s design, divided (n=32) above threshold (n=21). The identified 0.63 least common most common. Patients high had 100% (10/10) freedom (FFAF); at 1 ablated 88% (7/8) FFAF; low 50% (11/22) 46% (6/13) FFAF. Using algorithms detect presence AF, clinically heterogeneous population can be stratified distinct phenotypes guide minimum-required strategy, post-ablation prognosis. larger prognostication study warranted.