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Nonlinear Analysis of Fibrillatory Electrogram Similarity to Optimize the Detection of Complex Fractionated Electrograms During Persistent Atrial Fibrillation.
MedLine Citation:
PMID:  23130721     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Nonlinear Analysis of Atrial Fibrillation. Introduction: Currently, the identification of complex fractionated atrial electrograms (CFEs) in the substrate modification is mostly based on cycle length-derived algorithms. The characteristics of the fibrillation electrogram morphology and their consistency over time are not clear. The aim of this study was to optimize the detection algorithm of crucial CFEs by using nonlinear measure electrogram similarity. Methods and Results: One hundred persistent atrial fibrillation patients that underwent catheter ablation were included. In patients who required CFE ablation (79%), the time-domain fibrillation signals (6 seconds) were acquired for a linear analysis (mean fractionation interval and dominant frequency [DF]) and nonlinear-based waveform similarity analysis of the local electrograms, termed the similarity index (SI). Continuous CFEs were targeted with an endpoint of termination. Predictors of the various signal characteristics on the termination and clinical outcome were investigated. Procedural termination was observed in 39% and long-term sinus rhythm maintenance in 67% of the patients. The targeted CFEs didn't differ based on the linear analysis modalities between the patients who responded and did not respond to CFE ablation. In contrast, the average SI of the targeted CFEs was higher in termination patients, and they had a better outcome. Multivariate regression analysis showed that a higher SI independently predicted sites of termination (≥0.57; OR = 4.9; 95% CI = 1.33-18.0; P = 0.017). Conclusions: In persistent AF patients, a cycle length-based linear analysis could not differentiate culprit CFEs from bystanders. This study suggested that sites with a high level of fibrillation electrogram similarity at the CFE sites were important for AF maintenance. (J Cardiovasc Electrophysiol, Vol. pp. 1-10).
Authors:
Yenn-Jiang Lin; Men-Tzung Lo; Chen Lin; Shih-Lin Chang; Li-Wei Lo; Yu-Feng Hu; Tze-Fan Chao; Cheng-Hung Li; Yi-Chung Chang; Wan-Hsin Hsieh; Fa-Po Chung; Hsuan-Ming Tsao; Hung-Yu Chang; Norden E Huang; Shih-Ann Chen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-6
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
Affiliation:
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Internal Medicine, Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University and Hospital, Taipei, Taiwan Research Center for Adaptive Data Analysis Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan Divsion of Cardiology, National Yang-Ming University Hospital and National Yang-Ming University, Yi-Lan, Taiwan.
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