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A Novel Method of Signal Analysis for Ablation of Wolff-Parkinson-White Syndrome.
MedLine Citation:
PMID:  21872561     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Identification of the site of a successful radiofrequency catheter ablation (RFCA) for WPW may be subjective. OBJECTIVE: To develop an automated signal analysis program to predict a successful ablation site. METHODS: Patients who underwent successful RFCA for WPW from 2008-2010 at our center were analyzed. Inclusion criteria: Age < 21yrs, loss of pre-excitation in < 5 sec, and sustained success at 3 months. Exclusion criteria: Congenital heart disease, pacing during RFCA. The standard recording system signal was filtered into low (LF 0 - ≤ 0.02 Hz) and high (HF > 0.02 - ≤ 0.45 Hz) frequencies. Software identified the beginning of the HF signal, LF and R wave peaks, LF/HF signal amplitude, and area under the HF/LF signals. Successful and unsuccessful (RF applied without AP block) signals were compared. RESULTS: 30 patients were analyzed; 16 had both successful and unsuccessful signals, 14 had a successful ablation with one RF application. Mean age was 13.7 ± 3.1 years, weight 54.9 ± 22.4 kg, and time to AP ablation 1.7 ± 1.4 sec. Significant differences were found between successful and unsuccessful signals in area under HF signal, LF amplitude, LF to R time, HF ratio, and HF area x HF ratio. A ROC of HF area x HF ratio produced an AUC of 0.89. A HF area x HF ratio of 3.1 distinguished successful from unsuccessful signals with 100% specificity and 81% sensitivity. CONCLUSIONS: Automated signal analysis retrospectively differentiated successful from unsuccessful signals in patients undergoing RFCA for WPW. This software may improve safety and efficacy of RFCA in children.
Scott R Ceresnak; Gregory J Gates; Lynn Nappo; Hillel W Cohen; Robert H Pass
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-25
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Assistant Professor of Pediatrics, Albert Einstein College of Medicine, Division of Pediatric Cardiology, Pediatric Arrhythmia Service, The Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Rosenthal 1, Bronx, NY 10467-2490, Tel: (718) 741 - 2183, Fax: (718) 654 - 3024.
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