A hierarchical algorithm for causality discovery among atrial fibrillation electrograms

Multi-channel intracardiac electrocardiograms (electrograms) are sequentially acquired, at the electrophysiology laboratory, in order to guide radio frequency catheter ablation during heart surgery performed on patients with sustained atrial fibrillation (AF). These electrograms are used by cardiologists to determine candidate areas for ablation (e.g., areas corresponding to high dominant frequencies or complex fractionated electrograms). In this paper, we introduce a novel hierarchical algorithm for causality discovery among these multi-output sequentially acquired electrograms. The causal model obtained provides important information about the propagation of the electrical signals inside the heart, uncovering wavefronts and activation patterns that will serve to increase our knowledge about AF and guide cardiologists towards candidate areas for catheter ablation. Numerical results on synthetic signals, generated using the FitzHugh-Nagumo model, show the good performance of the proposed approach.