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Escribano P, Ródenas J, García M, Arias MA, Hidalgo VM, Calero S, Rieta JJ, Alcaraz R. Combination of frequency- and time-domain characteristics of the fibrillatory waves for enhanced prediction of persistent atrial fibrillation recurrence after catheter ablation. Heliyon 2024; 10:e25295. [PMID: 38327415 PMCID: PMC10847938 DOI: 10.1016/j.heliyon.2024.e25295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
Catheter ablation (CA) remains the cornerstone alternative to cardioversion for sinus rhythm (SR) restoration in patients with atrial fibrillation (AF). Unfortunately, despite the last methodological and technological advances, this procedure is not consistently effective in treating persistent AF. Beyond introducing new indices to characterize the fibrillatory waves (f-waves) recorded through the preoperative electrocardiogram (ECG), the aim of this study is to combine frequency- and time-domain features to improve CA outcome prediction and optimize patient selection for the procedure, given the absence of any study that jointly analyzes information from both domains. Precisely, the f-waves of 151 persistent AF patients undergoing their first CA procedure were extracted from standard V1 lead. Novel spectral and amplitude features were derived from these waves and combined through a machine learning algorithm to anticipate the intervention mid-term outcome. The power rate index (φ), which estimates the power of the harmonic content regarding the dominant frequency (DF), yielded the maximum individual discriminant ability of 64% to discern between individuals who experienced a recurrence of AF and those who sustained SR after a 9-month follow-up period. The predictive accuracy was improved up to 78.5% when this parameter φ was merged with the amplitude spectrum area in the DF bandwidth (A M S A L F ) and the normalized amplitude of the f-waves into a prediction model based on an ensemble classifier, built by random undersampling boosting of decision trees. This outcome suggests that the synthesis of both spectral and temporal features of the f-waves before CA might enrich the prognostic knowledge of this therapy for persistent AF patients.
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Affiliation(s)
- Pilar Escribano
- Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Albacete, Spain
| | - Juan Ródenas
- Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Albacete, Spain
| | - Manuel García
- Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Albacete, Spain
| | - Miguel A. Arias
- Cardiac Arrhythmia Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Víctor M. Hidalgo
- Cardiac Arrhythmia Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Sofía Calero
- Cardiac Arrhythmia Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - José J. Rieta
- BioMIT.org, Electronic Engineering Department, Universitat Politecnica de Valencia, Valencia, Spain
| | - Raúl Alcaraz
- Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Albacete, Spain
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McCann A, Luca A, Pascale P, Pruvot E, Vesin JM. Novel spatiotemporal processing tools for body-surface potential map signals for the prediction of catheter ablation outcome in persistent atrial fibrillation. Front Physiol 2022; 13:1001060. [PMID: 36246141 PMCID: PMC9557152 DOI: 10.3389/fphys.2022.1001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Signal processing tools are required to efficiently analyze data collected in body-surface-potential map (BSPM) recordings. A limited number of such tools exist for studying persistent atrial fibrillation (persAF). We propose two novel, spatiotemporal indices for processing BSPM data and test their clinical applicability through a comparison with the recently proposed non-dipolar component index (NDI) for prediction of single-procedure catheter ablation (CA) success rate in persAF patients.Methods: BSPM recordings were obtained with a 252-lead vest in 13 persAF patients (8 men, 63 ± 8 years, 11 ± 13 months sustained AF duration) before undergoing CA. Each recording was divided into seven 1-min segments of high signal quality. Spatiotemporal ventricular activity (VA) cancellation was applied to each segment to isolate atrial activity (AA). The two novel indices, called error-ratio, normalized root-mean-square error (ERNRMSE) and error-ratio, mean-absolute error (ERABSE), were calculated. These indices quantify the capacity of a subset of BSPM vest electrodes to accurately represent the AA, and AA dominant frequency (DF), respectively, on all BSPM electrodes over time, compared to the optimal principal component analysis (PCA) representation. The NDI, quantifying the fraction of energy retained after removal of the three largest PCs, was also calculated. The two novel indices and the NDI were statistically compared between patient groups based on single-procedure clinical CA outcome. Finally, their predictive power for univariate CA outcome classification was assessed using receiver operating characteristic (ROC) analysis with cross-validation for a logistic regression classifier.Results: Patient clinical outcomes were recorded 6 months following procedures, and those who had an arrhythmia recurrence at least 2 months post-CA were defined as having a negative outcome. Clinical outcome information was available for 11 patients, 6 with arrhythmia recurrence. Therefore, a total of 77 1-min AA-BSPM segments were available for analysis. Significant differences were found in the values of the novel indices and NDI between patients with arrhythmia recurrence post-ablation and those without. ROC analysis showed the best CA outcome predictive performance for ERNRMSE (AUC = 0.77 ± 0.08, sensitivity = 76.2%, specificity = 84.8%).Conclusion: Significant association was found between the novel indices and CA success or failure. The novel index ERNRMSE additionally shows good predictive power for single-procedure CA outcome.
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Affiliation(s)
- Anna McCann
- Applied Signal Processing Group, Department of Electrical Engineering, Swiss Federal Institute of Technology, Lausanne, Switzerland
- *Correspondence: Anna McCann,
| | - Adrian Luca
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Patrizio Pascale
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Etienne Pruvot
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Jean-Marc Vesin
- Applied Signal Processing Group, Department of Electrical Engineering, Swiss Federal Institute of Technology, Lausanne, Switzerland
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Park JI, Park SW, Kwon MJ, Lee J, Kim HJ, Lee CH, Shin DG. Surface ECG-based complexity parameters for predicting outcomes of catheter ablation for nonparoxysmal atrial fibrillation: efficacy of fibrillatory wave amplitude. Medicine (Baltimore) 2022; 101:e29949. [PMID: 35945788 PMCID: PMC9351908 DOI: 10.1097/md.0000000000029949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Catheter ablation (CA) is a well-established therapy for rhythm control in atrial fibrillation (AF). However, CA outcomes for persistent AF remain unsatisfactory because of the high recurrence rate despite time-consuming efforts and the latest ablation technology. Therefore, the selection of good responders to CA is necessary. Surface electrocardiography (sECG)-based complexity parameters were tested for the predictive ability of procedural termination failure during CA and late recurrence of atrial arrhythmias (AA) after CA. A total of 130 patients with nonparoxysmal AF who underwent CA for the first time were investigated. A 10-second sECG of 4 leads (leads I, II, V1, and V6) was analyzed to compute the fibrillatory wave amplitude (FWA), dominant frequency (DF), spectral entropy (SE), organization index (OI), and sample entropy (SampEn). The study endpoints were procedural termination failure during CA and late (≥1 year) AA recurrence after CA. In the multivariate analysis, FWA in lead V1 and DF in lead I were independent predictors of successful AF termination during CA (P <.05). The optimal cut-off values for FWA in lead V1 and DF in lead I were 60.38 μV (area under the curve [AUC], 0.672; P = .001) and 5.7 Hz (AUC, 0.630; P = .016), respectively. The combination of FWA of lead V1 and DF of lead I had a more powerful odds ratio for predicting procedural termination failure (OR, 8.542; 95% CI, 2.938-28.834; P < .001). FWA in lead V1 was the only independent predictor of late recurrence after CA. The cut-off value is 65.73 μV which was 0.634 of the AUC (P = .009). These sECG parameters, FWA in lead V1 and DF in lead I, predicted AF termination by CA in patients with nonparoxysmal AF. In particular, FWA in lead V1 was an independent predictor of late recurrence of AA after CA.
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Affiliation(s)
- Jong-Il Park
- Yeungnam University College of Medicine, Daegu, Korea
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | | | - Min-Ji Kwon
- Yeungnam University College of Medicine, Daegu, Korea
| | - Jeon Lee
- Lyda Hill Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hong-Ju Kim
- Yeungnam University College of Medicine, Daegu, Korea
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Chan-Hee Lee
- Yeungnam University College of Medicine, Daegu, Korea
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Dong-Gu Shin
- Yeungnam University College of Medicine, Daegu, Korea
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
- *Correspondence: Dong-Gu Shin, Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea (e-mail: )
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Squara F, Scarlatti D, Bun SS, Moceri P, Ferrari E, Meste O, Zarzoso V. Fibrillatory Wave Amplitude Evolution during Persistent Atrial Fibrillation Ablation: Implications for Atrial Substrate and Fibrillation Complexity Assessment. J Clin Med 2022; 11:jcm11154519. [PMID: 35956135 PMCID: PMC9369560 DOI: 10.3390/jcm11154519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/19/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Fibrillatory Wave Amplitude (FWA) has been described as a non-invasive marker of atrial fibrillation (AF) complexity, and it predicts catheter ablation outcome. However, the actual determinants of FWA remain incompletely understood. Objective. To assess the respective implications of anatomical atrial substrate and AF spectral characteristics for FWA. Methods. Persistent AF patients undergoing radiofrequency catheter ablation were included. FWA was measured on 1-min ECG by TQ concatenation in Lead I, V1, V2, and V5 at baseline and immediately before AF termination. FWA evolution during ablation was compared to that of AF dominant frequency (DF) measured by Independent Component Analysis on 12-lead ECG. FWA was compared to the extent of endocardial low-voltage areas (LVA I < 10%; II 10–20%; III 20–30%; IV > 30%), to the surface of healthy left atrial tissue, and to P-wave amplitude in sinus rhythm. The predictive value of FWA for AF recurrence during follow-up was assessed. Results. We included 29 patients. FWA remained stable along ablation procedure with comparable values at baseline and before AF termination (Lead I p = 0.54; V1 p = 0.858; V2 p = 0.215; V5 p = 0.14), whereas DF significantly decreased (5.67 ± 0.68 vs. 4.95 ± 0.58 Hz, p < 0.001). FWA was higher in LVA-I than in LVA-II, -III, and -IV in Lead I and V5 (p = 0.02 and p = 0.01). FWA in V5 was strongly correlated with the surface of healthy left atrial tissue (R = 0.786; p < 0.001). FWA showed moderate to strong correlation to P-wave amplitude in all leads. Finally, FWA did not predict AF recurrence after a follow-up of 23.3 ± 9.8 months. Conclusions. These findings suggest that FWA is unrelated to AF complexity but is mainly determined by the amount of viable atrial myocytes. Therefore, FWA should only be referred as a marker of atrial tissue pathology.
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Affiliation(s)
- Fabien Squara
- Cardiology Department, Université Côte d’Azur, Pasteur Hospital, 30 Avenue de la Voie Romaine, 06000 Nice, France; (D.S.); (S.-S.B.); (P.M.); (E.F.)
- I3S Laboratory, Université Côte d’Azur, CNRS, 06900 Sophia Antipolis, France; (O.M.); (V.Z.)
- Correspondence: ; Tel.: +33-6-2016-5829
| | - Didier Scarlatti
- Cardiology Department, Université Côte d’Azur, Pasteur Hospital, 30 Avenue de la Voie Romaine, 06000 Nice, France; (D.S.); (S.-S.B.); (P.M.); (E.F.)
| | - Sok-Sithikun Bun
- Cardiology Department, Université Côte d’Azur, Pasteur Hospital, 30 Avenue de la Voie Romaine, 06000 Nice, France; (D.S.); (S.-S.B.); (P.M.); (E.F.)
| | - Pamela Moceri
- Cardiology Department, Université Côte d’Azur, Pasteur Hospital, 30 Avenue de la Voie Romaine, 06000 Nice, France; (D.S.); (S.-S.B.); (P.M.); (E.F.)
| | - Emile Ferrari
- Cardiology Department, Université Côte d’Azur, Pasteur Hospital, 30 Avenue de la Voie Romaine, 06000 Nice, France; (D.S.); (S.-S.B.); (P.M.); (E.F.)
| | - Olivier Meste
- I3S Laboratory, Université Côte d’Azur, CNRS, 06900 Sophia Antipolis, France; (O.M.); (V.Z.)
| | - Vicente Zarzoso
- I3S Laboratory, Université Côte d’Azur, CNRS, 06900 Sophia Antipolis, France; (O.M.); (V.Z.)
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Ghrissi A, Almonfrey D, Squara F, Montagnat J, Zarzoso V. Identification of spatiotemporal dispersion electrograms in atrial fibrillation ablation using machine learning: A comparative study. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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İçen YK, Koca H, Sümbül HE, Yıldırım A, Koca F, Yıldırım A, Ardıc ML, Coşkun M, Uğurlu M, Koç M. Relationship between coarse F waves and thromboembolic events in patients with permanent atrial fibrillation. J Arrhythm 2020; 36:1025-1031. [PMID: 33335620 PMCID: PMC7733569 DOI: 10.1002/joa3.12430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The coarse F waves on the 12-lead surface electrocardiogram (ECG) in patients with atrial fibrillation (AF) are known as atrial viability and contractility indicator. Our aim in this study was to investigate the effect of coarse F wave on thromboembolism in patients with permanent AF. METHODS In our study, 328 patients with permanent AF were included. Routine laboratory, echocardiographic and electrocardiographic parameters were examined. Cerebrovascular event (CVE) or acute artery occlusion was considered a thromboembolic event. RESULTS In our study, 46 (14.0%) of the patients were found to have thromboembolic events and 282 (86%) of them were found without thromboembolic events. In the group with thromboembolic event, the number of patients with hypertension (HT) (P < .001) and history of coronary artery disease (P = .003) and elderly patients (P < .001) was significantly higher and warfarin use was significantly lower (P = .025). In the group of patients without thromboembolic events, the number of patients with a coarse F wave in surface ECG was significantly lower (P = .001). Age (OR: 1.105, 95% CI: 1.066-1.145, P < .001), HT (OR: 2.831, 95% CI: 1.266-6.331, P = .011), and coarse F wave (OR: 0.290, 95% CI: 0.126- 0.670, P = .004) were determined as independent variables for thromboembolic events. CONCLUSION Coarse F wave in 12-lead surface ECG in patients with permanent AF may be associated with good prognosis.
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Affiliation(s)
- Yahya Kemal İçen
- Department of CardiologyUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
| | - Hasan Koca
- Department of CardiologyUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
| | - Hilmi Erdem Sümbül
- Department of Internal MedicineUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
| | - Arafat Yıldırım
- Department of CardiologyUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
| | - Fadime Koca
- Department of CardiologyUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
| | - Abdullah Yıldırım
- Department of CardiologyUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
| | - Mustafa Lutfullah Ardıc
- Department of CardiologyUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
| | - Mükremin Coşkun
- Department of CardiologyUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
| | - Mehmet Uğurlu
- Göksun State Hospital Cardiology DepartmentKahramanmaraşTurkey
| | - Mevlüt Koç
- Department of CardiologyUniversity of Health Sciences ‐ Adana Health Practice and Research CenterAdanaTurkey
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Laţcu DG, Bun SS, Casado Arroyo R, Wedn AM, Benaich FA, Hasni K, Enache B, Saoudi N. Scar identification, quantification, and characterization in complex atrial tachycardia: a path to targeted ablation? Europace 2020; 21:i21-i26. [PMID: 30801130 DOI: 10.1093/europace/euy182] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 07/23/2018] [Indexed: 01/21/2023] Open
Abstract
Successful catheter ablation of scar-related atrial tachycardia depends on correct identification of the critical isthmus. Often, this is a represented by a small bundle of viable conducting tissue within a low-voltage area. It's identification depends on the magnitude of the signal/noise ratio. Ultra-high density mapping, multipolar catheters with small (eventually unidirectional) and closely-spaced electrodes improves low-voltage electrogram detection. Background noise limitation is also of major importance for improving the signal/noise ratio. Electrophysiological properties of the critical isthmus and the characteristics of the local bipolar electrograms have been recently demonstrated as hallmarks of successful ablation sites in the setting of scar-related atrial tachycardia.
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Affiliation(s)
| | - Sok-Sithikun Bun
- Service de Cardiologie, Centre Hospitalier Princesse Grace, Avenue Pasteur, Monaco
| | - Ruben Casado Arroyo
- Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Ahmed Moustfa Wedn
- Service de Cardiologie, Centre Hospitalier Princesse Grace, Avenue Pasteur, Monaco
| | | | - Karim Hasni
- Service de Cardiologie, Centre Hospitalier Princesse Grace, Avenue Pasteur, Monaco
| | - Bogdan Enache
- Service de Cardiologie, Centre Hospitalier Princesse Grace, Avenue Pasteur, Monaco
| | - Nadir Saoudi
- Service de Cardiologie, Centre Hospitalier Princesse Grace, Avenue Pasteur, Monaco
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8
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Short-term reproducibility of parameters characterizing atrial fibrillatory waves. Comput Biol Med 2020; 117:103613. [DOI: 10.1016/j.compbiomed.2020.103613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/04/2020] [Accepted: 01/07/2020] [Indexed: 11/21/2022]
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9
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Henriksson M, García-Alberola A, Goya R, Vadillo A, Melgarejo-Meseguer FM, Sandberg F, Sörnmo L. Changes in f-wave characteristics during cryoballoon catheter ablation. Physiol Meas 2018; 39:105001. [PMID: 30183676 DOI: 10.1088/1361-6579/aadf1d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Changes in ECG-derived parameters are studied in atrial fibrillation (AF) patients undergoing cryoballoon catheter ablation. APPROACH Parameters characterizing f-wave frequency, morphology by phase dispersion, and amplitude are estimated using a model-based statistical approach. These parameters are studied before, during, and after ablation, as well as for AF type (paroxysmal/persistent). Seventy-seven (49/28 paroxysmal/persistent) AF patients undergoing de novo catheter ablation are included in the study, out of which 31 (16/15 paroxysmal/persistent) were in AF during the whole procedure. A signal quality index (SQI) is used to identify analyzable segments. MAIN RESULTS f-wave frequency decreased significantly during ablation (p = 0.001), in particular after ablation of the inferior right pulmonary vein (p < 0.05). Frequency and phase dispersion differed significantly between paroxysmal and persistent AF (p = 0.001 and p < 0.05, respectively). SIGNIFICANCE This study demonstrates that a decrease in f-wave frequency can be distinguished during catheter ablation. The use of an SQI ensures reliable analysis and produces results significantly different from those obtained without an SQI.
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Affiliation(s)
- Mikael Henriksson
- Department of Biomedical Engineering and Center of Integrative Electrocardiology, Lund University, Lund, Sweden
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10
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Zhao TX, Martin CA, Cooper JP, Gajendragadkar PR. Coarse fibrillatory waves in atrial fibrillation predict success of electrical cardioversion. Ann Noninvasive Electrocardiol 2017; 23:e12528. [PMID: 29271577 DOI: 10.1111/anec.12528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 11/26/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND To determine whether the presence of "coarse" fibrillatory waves (Fw) seen on surface ECGs of patients with persistent atrial fibrillation (AF) predict maintenance of sinus rhythm (SR) at 6 weeks after electrical cardioversion (ECV). METHODS Preprocedure ECGs from 94 consecutive patients with persistent AF scheduled to undergo ECV at a single centre were classified as having coarse Fw (≥0.1 mV) or fine Fw (<0.1 mV) in leads II or V1 . The primary outcome was ECG rhythm at 6-week clinical follow-up. Demographic and echocardiographic data were also collected. RESULTS Thirty-two patient ECGs (34%) had coarse Fw on baseline ECG in either or both leads II or V1 with no significant differences in baseline demographics compared to those patients with fine Fw. At 6 weeks post-ECV, in the coarse Fw group 72% of patients maintained SR vs. 42% in the fine Fw group (χ2 , p = .006) with the odds ratio (OR) of maintaining SR at 6 weeks in the presence of coarse Fw being 3.5 (95% CI: 1.4-8.9, p = .007). Across the overall study population, there were no other significant univariate predictors of SR at 6 weeks post-ECV. CONCLUSION Classifying persistent AF using the maximal Fw amplitude on a surface ECG is a simple and reproducible method of predicting medium-term success of ECV, independent of traditional risk factors.
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Affiliation(s)
- Tian X Zhao
- Department of Cardiology, Bedford Hospital, Bedford, UK.,Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Claire A Martin
- Department of Cardiology, Bedford Hospital, Bedford, UK.,Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - John P Cooper
- Department of Cardiology, Bedford Hospital, Bedford, UK
| | - Parag R Gajendragadkar
- Department of Cardiology, Bedford Hospital, Bedford, UK.,Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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11
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Spectral and spatiotemporal variability ECG parameters linked to catheter ablation outcome in persistent atrial fibrillation. Comput Biol Med 2017; 88:126-131. [DOI: 10.1016/j.compbiomed.2017.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/17/2017] [Accepted: 07/03/2017] [Indexed: 11/21/2022]
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