Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory Waves
Catheter ablation (CA) is a commonly used treatment for persistent atrial fibrillation (AF). Since its medium/long-term success rate remains limited, preoperative prediction of its outcome is gaining clinical interest to optimally select candidates for the procedure. Among predictors based on the su...
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| Format: | Article |
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MDPI AG
2022-10-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/10/1721 |
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| author | Pilar Escribano Juan Ródenas Manuel García Miguel A. Arias Víctor M. Hidalgo Sofía Calero José J. Rieta Raúl Alcaraz |
| author_facet | Pilar Escribano Juan Ródenas Manuel García Miguel A. Arias Víctor M. Hidalgo Sofía Calero José J. Rieta Raúl Alcaraz |
| author_sort | Pilar Escribano |
| collection | DOAJ |
| description | Catheter ablation (CA) is a commonly used treatment for persistent atrial fibrillation (AF). Since its medium/long-term success rate remains limited, preoperative prediction of its outcome is gaining clinical interest to optimally select candidates for the procedure. Among predictors based on the surface electrocardiogram, the dominant frequency (DF) and harmonic exponential decay (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>γ</mi></semantics></math></inline-formula>) of the fibrillatory waves (<i>f</i>-waves) have reported promising but clinically insufficient results. Hence, the main goal of this work was to conduct a broader analysis of the <i>f</i>-wave harmonic spectral structure to improve CA outcome prediction through several entropy-based measures computed on different frequency bands. On a database of 151 persistent AF patients under radio-frequency CA and a follow-up of 9 months, the newly introduced parameters discriminated between patients who relapsed to AF and those who maintained SR at about 70%, which was statistically superior to the DF and approximately similar to <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>γ</mi></semantics></math></inline-formula>. They also provided complementary information to <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>γ</mi></semantics></math></inline-formula> through different combinations in multivariate models based on lineal discriminant analysis and report classification performance improvement of about 5%. These results suggest that the presence of larger harmonics and a proportionally smaller DF peak is associated with a decreased probability of AF recurrence after CA. |
| first_indexed | 2024-03-09T19:57:56Z |
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| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T19:57:56Z |
| publishDate | 2022-10-01 |
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| series | Journal of Personalized Medicine |
| spelling | doaj.art-545c892ffa8646b0ad0d30641e2b2d262023-11-24T00:50:54ZengMDPI AGJournal of Personalized Medicine2075-44262022-10-011210172110.3390/jpm12101721Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory WavesPilar Escribano0Juan Ródenas1Manuel García2Miguel A. Arias3Víctor M. Hidalgo4Sofía Calero5José J. Rieta6Raúl Alcaraz7Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, 02071 Albacete, SpainResearch Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, 02071 Albacete, SpainResearch Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, 02071 Albacete, SpainCardiac Arrhythmia Department, Complejo Hospitalario Universitario de Toledo, 45007 Toledo, SpainCardiac Arrhythmia Department, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, SpainCardiac Arrhythmia Department, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, SpainBioMIT.org, Electronic Engineering Department, Universitat Politecnica de Valencia, 46022 Valencia, SpainResearch Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, 02071 Albacete, SpainCatheter ablation (CA) is a commonly used treatment for persistent atrial fibrillation (AF). Since its medium/long-term success rate remains limited, preoperative prediction of its outcome is gaining clinical interest to optimally select candidates for the procedure. Among predictors based on the surface electrocardiogram, the dominant frequency (DF) and harmonic exponential decay (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>γ</mi></semantics></math></inline-formula>) of the fibrillatory waves (<i>f</i>-waves) have reported promising but clinically insufficient results. Hence, the main goal of this work was to conduct a broader analysis of the <i>f</i>-wave harmonic spectral structure to improve CA outcome prediction through several entropy-based measures computed on different frequency bands. On a database of 151 persistent AF patients under radio-frequency CA and a follow-up of 9 months, the newly introduced parameters discriminated between patients who relapsed to AF and those who maintained SR at about 70%, which was statistically superior to the DF and approximately similar to <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>γ</mi></semantics></math></inline-formula>. They also provided complementary information to <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>γ</mi></semantics></math></inline-formula> through different combinations in multivariate models based on lineal discriminant analysis and report classification performance improvement of about 5%. These results suggest that the presence of larger harmonics and a proportionally smaller DF peak is associated with a decreased probability of AF recurrence after CA.https://www.mdpi.com/2075-4426/12/10/1721persistent atrial fibrillationcatheter ablationoutcome predictionfibrillatory wave analysiselectrocardiogramspectral analysis |
| spellingShingle | Pilar Escribano Juan Ródenas Manuel García Miguel A. Arias Víctor M. Hidalgo Sofía Calero José J. Rieta Raúl Alcaraz Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory Waves Journal of Personalized Medicine persistent atrial fibrillation catheter ablation outcome prediction fibrillatory wave analysis electrocardiogram spectral analysis |
| title | Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory Waves |
| title_full | Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory Waves |
| title_fullStr | Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory Waves |
| title_full_unstemmed | Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory Waves |
| title_short | Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory Waves |
| title_sort | preoperative prediction of catheter ablation outcome in persistent atrial fibrillation patients through spectral organization analysis of the surface fibrillatory waves |
| topic | persistent atrial fibrillation catheter ablation outcome prediction fibrillatory wave analysis electrocardiogram spectral analysis |
| url | https://www.mdpi.com/2075-4426/12/10/1721 |
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