Computational mapping in atrial fibrillation: how the integration of signal-derived maps may guide the localization of critical sources

This article discusses the latest development in computational mapping for the identification and localization of critical sources in patients with atrial fibrillation (AF). It focuses on the contribution of electrogram-derived anatomical maps, obtained by applying innovative signal and image processing methodologies, to the investigation of the mechanisms underlying the arrhythmia and to the planning of new target ablation strategies. Reviewed are the experimental studies which allowed to infer the peculiar rate and regularity features of critical sources, the signal processing methods for the quantification of these parameters from atrial electrograms, and the clinical studies mapping rate and organization in AF patients. Finally, we present a novel methodological framework, based on the construction of the logic operation map, designed to merge in a single map the most relevant electrophysiological and anatomical features of the AF process, which may guide the selective identification of critical sources.