M.Sc. Mark Nothstein

Research Associate
room: 413.1
phone: +49 721 608 - 48232
fax: +49 721 608 - 42789
Mark NothsteinKwa7∂kit edu

Research
title	contact
Characterization of the electrophysiological substrate in patients with atrial fibrillation - Role of the restitution of atrial conduction velocity and of the voltage for the development of atrial fibrillation	Mark Nothstein, Olaf Dössel, Axel Loewe

Current thesis
title	type	person in charge	tutor
Implementation and assessment of a statistical fitting approach for detection of conduction velocity, anisotropy ratio and fiber orientation of cardiac tissue	Bachelor thesis	Johannes Tischer	M.Sc. Mark Nothstein

Completed thesis
title	type	person in charge	tutor
Determination and Transformation of conduction velocities during a catheter study using a computational model	Bachelor thesis	Christoph Luz	M.Sc. Mark Nothstein

Publications

All Publications, sorted by years

2020 [All]

Selected Publications

Journal Articles (1)

A. Jadidi, M. Nothstein, J. Chen, H. Lehrmann, O. Dössel, J. Allgeier, D. Trenk, F.-J. Neumann, A. Loewe, B. Müller-Edenborn, and T. Arentz.
Specific Electrogram Characteristics Identify the Extra-Pulmonary Vein Arrhythmogenic Sources of Persistent Atrial Fibrillation - Characterization of the Arrhythmogenic Electrogram Patterns During Atrial Fibrillation and Sinus Rhythm..
In Scientific Reports, vol. 10(1) , pp. 9147, 2020

Abstract:

Identification of atrial sites that perpetuate atrial fibrillation (AF), and ablation thereof terminates AF, is challenging. We hypothesized that specific electrogram (EGM) characteristics identify AF-termination sites (AFTS). Twenty-one patients in whom low-voltage-guided ablation after pulmonary vein isolation terminated clinical persistent AF were included. Patients were included if short RF-delivery for <8sec at a given atrial site was associated with acute termination of clinical persistent AF. EGM-characteristics at 21 AFTS, 105 targeted sites without termination and 105 non-targeted control sites were analyzed. Alteration of EGM-characteristics by local fibrosis was evaluated in a three-dimensional high resolution (100 µm)-computational AF model. AFTS demonstrated lower EGM-voltage, higher EGM-cycle-length-coverage, shorter AF-cycle-length and higher pattern consistency than control sites (0.49 ± 0.39 mV vs. 0.83 ± 0.76 mV, p < 0.0001; 79 ± 16% vs. 59 ± 22%, p = 0.0022; 173 ± 49 ms vs. 198 ± 34 ms, p = 0.047; 80% vs. 30%, p < 0.01). Among targeted sites, AFTS had higher EGM-cycle-length coverage, shorter local AF-cycle-length and higher pattern consistency than targeted sites without AF-termination (79 ± 16% vs. 63 ± 23%, p = 0.02; 173 ± 49 ms vs. 210 ± 44 ms, p = 0.002; 80% vs. 40%, p = 0.01). Low voltage (0.52 ± 0.3 mV) fractionated EGMs (79 ± 24 ms) with delayed components in sinus rhythm ('atrial late potentials', respectively 'ALP') were observed at 71% of AFTS. EGMs recorded from fibrotic areas in computational models demonstrated comparable EGM-characteristics both in simulated AF and sinus rhythm. AFTS may therefore be identified by locally consistent, fractionated low-voltage EGMs with high cycle-length-coverage and rapid activity in AF, with low-voltage, fractionated EGMs with delayed components/ 'atrial late potentials' (ALP) persisting in sinus rhythm.