Optimizing Atrial Electrogram Classification Based on Local Ablation Outcome in Human Atrial Fibrillation

Author(s):Show less -

Bezerra, Arthur S. ; Yoneyama, Takashi ; Soriano, Diogo C. ; Luongo, Giorgio ; Li, Xin ; Ravelli, Flavia ; Mase, Michela ; Chu, Gavin S. ; Stafford, Peter J. ; Schlindwein, Fernando S. ; Ng, G. Andre ; de Almeida, Tiago P. ; IEEE

• Document type: Journal article
• Source: 2020 COMPUTING IN CARDIOLOGY; v. N/A, p. 4-pg., 2020-01-01.

Abstract

Changes in atrial fibrillation cycle length (AF-CL) are broadly used as a 'ground truth' to assess the effect of substrate modification during AF ablation. This work sought to optimize thresholds for changes in coronary sinus CL (CS-CL) after local ablation using different atrial electrogram (AEG)-derived markers. 834 AEGs were collected from 11 patients undergoing persAF ablation. CS-CL was measured before and after each ablation point. Five AEG-derived markers were tested as classifiers for CS-CL changes: ICL (Biosense Webster), CFE-Mean (St. Jude Medical), Wave Similarity, Shannon Entropy and AEG-CL. The area under the receiver operating characteristic (AUROC) curve was used to assess the quality of classification for each marker. Maximum AUROC was found at threshold values between 9 and 14 ms in all markers, except for Shannon Entropy. The average AUROC of the five markers reached a maximum of 0.60 at a threshold value of 10 ms. The 10 ms threshold is suggested as a starting setpoint for future studies seeking to identify AF ablation targets based on an objective 'ground truth'. (AU)

• FAPESP's process: 18/02251-4 - Characterizing persistent atrial fibrillation dynamics using computational models and recurrence quantification analysis - towards novel biomarkers for guiding therapy
• Grantee: Tiago Paggi de Almeida
• Support Opportunities: Scholarships abroad - Research Internship - Post-doctor
• FAPESP's process: 19/09512-0 - Nonlinear dynamic functional connectivity analysis via recurrence quantification and its application to brain computer-interfaces
• Grantee: Diogo Coutinho Soriano
• Support Opportunities: Scholarships abroad - Research
• FAPESP's process: 17/00319-8 - Atrial substrate identification in patients with chronic atrial fibrillation using multivariate statistical models and multiple attributes from atrial electrograms
• Grantee: Tiago Paggi de Almeida
• Support Opportunities: Scholarships in Brazil - Post-Doctoral