The temporal behavior and consistency of bipolar atrial electrograms in human persistent atrial fibrillation.pdf (2.54 MB)
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The temporal behavior and consistency of bipolar atrial electrograms in human persistent atrial fibrillation

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journal contribution
posted on 27.03.2018, 13:34 by Tiago P. Almeida, GS Chu, Michael J. Bell, Xin Li, JL Salinet, N Dastagir, JH Tuan, PJ Stafford, G André Ng, Fernando S. Schlindwein
The unstable temporal behavior of atrial electrical activity during persistent atrial fibrillation (persAF) might influence ablation target identification, which could explain the conflicting persAF ablation outcomes in previous studies. We sought to investigate the temporal behavior and consistency of atrial electrogram (AEG) fractionation using different segment lengths. Seven hundred ninety-seven bipolar AEGs were collected with three segment lengths (2.5, 5,and 8 s) from 18 patients undergoing persAF ablation. The AEGs with 8-s duration were divided into three 2.5-s consecutive segments. AEG fractionation classification was applied off-line to all cases following the CARTO criteria; 43% of the AEGs remained fractionated for the three consecutive AEG segments, while nearly 30% were temporally unstable. AEG classification within the consecutive segments had moderate correlation (segment 1 vs 2: Spearman's correlation ρ = 0.74, kappa score κ = 0.62; segment 1 vs 3: ρ = 0.726, κ = 0.62; segment 2 vs 3: ρ = 0.75, κ = 0.68). AEG classifications were more similar between AEGs with 5 and 8 s (ρ = 0.96, κ = 0.87) than 2.5 versus 5 s (ρ = 0.93, κ = 0.84) and 2.5 versus 8 s (ρ = 0.90, κ = 0.78). Our results show that the CARTO criteria should be revisited and consider recording duration longer than 2.5 s for consistent ablation target identification in persAF.

History

Citation

Medical and Biological Engineering and Computing, 2018, 56 (1), pp. 71-83

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

VoR (Version of Record)

Published in

Medical and Biological Engineering and Computing

Publisher

Springer Verlag

issn

0140-0118

eissn

1741-0444

Acceptance date

10/06/2017

Copyright date

2017

Available date

27/03/2018

Publisher version

https://link.springer.com/article/10.1007/s11517-017-1667-1

Language

en