2016 - CBEB - Almeida et al - AEGs Temporal Consistency - Manuscript_rev1.pdf (516.76 kB)
The spatio-temporal behavior of atrial electrogram fractionation in persistent Atrial Fibrillation
conference contribution
posted on 2016-11-14, 09:53 authored by Tiago P. Almeida, Gavin S. Chu, Michael J. Bell, Xin Li, J. Salinet, Nawshin Dastagir, Jiun H. Tuan, Peter J. Stafford, G. André Ng, Fernando S. SchlindweinThe temporal behavior of atrial electrograms
(AEGs) during persistent atrial fibrillation (persAF)
remains poorly understood. In the present work, we
investigated the temporal behavior of consecutive AEGs
and the consistency of complex fractionated atrial
electrograms (CFAEs) with the CARTO (Biosense
Webster) criterion. 797 bipolar AEGs were exported from
NavX (St. Jude Medical) with three segment lengths (2.5
s, 5 s and 8 s) from 18 patients undergoing persAF
ablation. Three 2.5 s consecutive segments were created
from the 8 s AEGs. CFAE classification was applied
offline to all cases following the CARTO criterion.
CFAEs were defined as AEGs with the interval
confidence level (ICL) ≥4. Moderate correlation was
found in AEG classification between the consecutive
segments (segment 1 vs 2: Spearman’s correlation
ρ=0.74, Kappa score κ=0.62; segment 1 vs 3: ρ=0.72;
κ=0.62; segment 2 vs 3: ρ=0.75; κ=0.68), resulting in
different CFAE maps. AEGs with 5 s generated AEG
classification more similar to 8 s (ρ=0.96; κ=0.87) than
2.5 s vs 5 s (ρ=0.93; κ=0.84) and 2.5 s vs 8 s (ρ=0.90;
κ=0.78). The results suggest that consecutive 2.5 s AEGs
resulted in different ablation target identification, which
would affect the ablation strategy and contribute to the
conflicting outcomes in AEG-guided ablation of persAF.
CARTO criterion should be revisited in clinic and
consider AEGs with longer duration for consistent CFAE
classification in persAF.
Funding
The research leading to these results was funded by the Leicester NIHR Cardiovascular Biomedical Research Unit, UK. TPA and JS received research grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.
History
Citation
XXV Congresso Brasileiro de Engenharia Biomédica – CBEB 2016, Brazil 2016Author affiliation
/Organisation/COLLEGE OF SCIENCE AND ENGINEERING/Department of EngineeringSource
XXV Congresso Brasileiro de Engenharia Biomédica – CBEB 2016, Brazil 2016Version
- VoR (Version of Record)