A High Baseline Electrographic Organization Level Is Predictive of Successful Termination of Persistent Atrial Fibrillation by Catheter Ablation

JACC. Clinical Electrophysiology
Andrea ButtuEtienne Pruvot

Abstract

This study sought to investigate whether the level of organization of electrocardiographic (ECG) signals based on novel indexes is predictive of persistent atrial fibrillation (pAF) termination by catheter ablation (CA). Whether the level of ECG organization in pAF is correlated with the restoration of sinus rhythm by CA remains unknown. Thirty consecutive patients who underwent stepwise CA for pAF (sustained duration 19 ± 11 months) were included in the study (derivation cohort). ECG lead V6 was placed on the patients' back (V6b) to improve left atrial (LA) recording. Two novel ECG indexes were computed using an adaptive harmonic frequency tracking scheme: 1) the adaptive organization index (AOI), which quantifies the cyclicity of AF harmonic oscillations; and 2) the adaptive phase index (API), which quantifies the phase coupling between the harmonic components. Index cutoff values predictive of procedural AF termination were then tested on a validation cohort of 8 consecutive patients. In the derivation cohort, CA terminated AF in 21 patients within the LA (70%; left-terminated [LT] group), whereas CA did not terminate AF in 9 patients (30%; non-left-terminated [NLT] group). LT patients displayed a higher ECG organization lev...Continue Reading

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Citations

Aug 30, 2019·Arrhythmia & Electrophysiology Review·Nicolas JohnerDipen C Shah
Dec 15, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Adrian LucaEtienne Pruvot

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