Development of a computer algorithm for the detection of phase singularities and initial application to analyze simulations of atrial fibrillation

<jats:p>Atrial fibrillation (AF) is a common cardiac arrhythmia, but its mechanisms are incompletely understood. The identification of phase singularities (PSs) has been used to define spiral waves involved in maintaining the arrhythmia, as well as daughter wavelets. In the past, PSs have often been identified manually. Automated PS detection algorithms have been described previously, but when we attempted to apply a previously developed algorithm we experienced problems with false positives that made the results difficult to use directly. We therefore developed a tool for PS identification that uses multiple strategies incorporating both image analysis and mathematical convolution for automated detection with optimized sensitivity and specificity, followed by manual verification. The tool was then applied to analyze PS behavior in simulations of AF maintained in the presence of spatially distributed acetylcholine effects in cell grids of varying size. These analyses indicated that in almost all cases, a single PS lasted throughout the simulation, corresponding to the central-core tip of a single spiral wave that maintained AF. The sustained PS always localized to an area of low acetylcholine concentration. When the grid became very small and no area of low acetylcholine concentration was surrounded by zones of higher concentration, AF could not be sustained. The behavior of PSs and the mechanisms of AF were qualitatively constant over an 11.1-fold range of atrial grid size, suggesting that the classical emphasis on tissue size as a primary determinant of fibrillatory behavior may be overstated.</jats:p>