Dynamics of Intraprocedural Dominant Frequency Identifies Ablation Outcome in Persistent Atrial Fibrillation.

Details

Serval ID
serval:BIB_3D2AD5A11C76
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Dynamics of Intraprocedural Dominant Frequency Identifies Ablation Outcome in Persistent Atrial Fibrillation.
Journal
Frontiers in physiology
Author(s)
Pithon Alain, McCann Anna, Buttu Andrea, Vesin Jean-MArc, Pascale Patrizio, Le Bloa Mathieu, Herrera Claudia, Park C.han-il, Roten Laurent, Kühne Michael, Spies Florian, Knecht Sven, Sticherling Christian, Pruvot Etienne (co-last), Luca Adrian (co-last)
ISSN
1664-042X (Print)
ISSN-L
1664-042X
Publication state
Published
Issued date
2021
Peer-reviewed
Oui
Volume
12
Pages
731917
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Background: The role of dominant frequency (DF) in tracking the efficiency of a stepwise catheter ablation (step-CA) in persistent atrial fibrillation (peAF) remains poorly studied. We hypothesized that the DF time-course during step-CA displays divergent patterns between patients in whom a step-CA successfully restores long-term sinus rhythm (SR) and those with recurrence. Methods: This study involved 40 consecutive patients who underwent a step-CA for peAF (sustained duration 19 ± 11 months). Dominant frequency was computed on electrograms recorded from the right and left atrial appendages (RAA; LAA) and the coronary sinus before and during the step-CA synchronously to the 12-lead ECG. Dominant frequency was defined as the highest peak within the power spectrum. Results: Persistent atrial fibrillation was terminated by a step-CA in 28 patients [left-terminated (LT)], whereas 12 patients remaining in AF after ablation [not left-terminated (NLT)] were cardioverted. Over a mean follow-up of 34 ± 14 months, all NLT patients had a recurrence. Among the 28 LT patients, 20 had a recurrence, while 8 remained in SR throughout follow-up. The RAA and V <sub>1</sub> DF had the best predictive values of the procedural failure to terminate AF (area under the curve; AUC 0.84, p < 0.05). A decision tree model including a decrease in LAA DF ≥ 6.61% during the first 20 min following pulmonary vein isolation (PVI) and a baseline RAA DF <5.6 Hz predicted long-term SR restoration with a sensitivity of 83% and a specificity of 93% (p < 0.05). Conclusion: This study found that high baseline DF values are predictive of unfavorable ablation outcomes. The reduction of the LAA DF at early ablation steps following PVI is associated with procedural AF termination and long-term SR maintenance.
Keywords
atrial fibrillation, catheter ablation, decision tree model, dominant frequency, intracardiac electrogram, surface electrocardiogram
Pubmed
Web of science
Open Access
Yes
Create date
09/11/2021 12:16
Last modification date
11/06/2022 6:35
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