Heart Rhythm, 10(9), 1303–1310p. (2013) DOI:10.1016/j.hrthm.2013.06.007

Characteristics of atrial fibrillation cycle length predict restoration of sinus rhythm by catheter ablation

L. Y. Di Marco, D. Raine, J. P. Bourke, P. Langley

Background Successful termination of atrial fibrillation (AF) during catheter ablation (CA) is associated with arrhythmia-free follow-up. Preablation factors such as mean atrial fibrillation cycle length (AFCL) predict the likelihood of AF termination during ablation but recurring patterns and AFCL stability have not been evaluated.

Objective To investigate novel predictors of acute and postoperative ablation outcomes from intracardiac electrograms: (1) recurring AFCL patterns and (2) localization index (LI) of the instantaneous fibrillatory rate distribution.

Methods Sixty-two patients with AF (32 paroxysmal AF; 45 men; age 57 +/- 10 years) referred for CA were enrolled. One-minute electrogram was recorded from coronary sinus (CS; 5 bipoles) and right atrial appendage (HRA; 2 bipoles). Atrial activations were detected automatically to derive the AFCL and instantaneous fibrillatory rate (inverse of AFCL) time series. Recurring AFCL patterns were quantified by using recurrence plot indices (RPIs): percentage determinism, entropy of determinism, and maximum diagonal length. AFCL stability was determined by using the LI. The CA outcome predictivity of individual indices was assessed.

Results Patients with terminated atrial fibrillation (T-AF) had higher RPI (P < .05 in CS7-8) and LI than did those with nonterminated atrial fibrillation (P < .005 in CS3-4; P < .05 in CS5-6, CS7-8, and HRA). Patients free of arrhythmia after 3-month follow-up had higher RPI and LI (all P < .05 in CS7-8). All indices except percentage determinism predicted T-AF in CS7-8 (area under the curve [AUC] >= 0.71; odds ratio [OR] >= 4.50; P < .05). The median AFCL and LI predicted T-AF in HRA(D) (AUC >= 0.75; OR >= 7.76; P < .05). The RPI and LI predicted 3-month follow-up in CS7-8 (AUC >= 0.68; OR >= 4.17; P < .05).

Conclusions AFCL recurrence and stability indices could be used in selecting patients more likely to benefit from CA.

back


Creative Commons License © 2017 SOME RIGHTS RESERVED
The content of this web site is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Germany License.

Please note: The abstracts of the bibliography database may underly other copyrights.

Ihr Browser versucht gerade eine Seite aus dem sogenannten Internet auszudrucken. Das Internet ist ein weltweites Netzwerk von Computern, das den Menschen ganz neue Möglichkeiten der Kommunikation bietet.

Da Politiker im Regelfall von neuen Dingen nichts verstehen, halten wir es für notwendig, sie davor zu schützen. Dies ist im beidseitigen Interesse, da unnötige Angstzustände bei Ihnen verhindert werden, ebenso wie es uns vor profilierungs- und machtsüchtigen Politikern schützt.

Sollten Sie der Meinung sein, dass Sie diese Internetseite dennoch sehen sollten, so können Sie jederzeit durch normalen Gebrauch eines Internetbrowsers darauf zugreifen. Dazu sind aber minimale Computerkenntnisse erforderlich. Sollten Sie diese nicht haben, vergessen Sie einfach dieses Internet und lassen uns in Ruhe.

Die Umgehung dieser Ausdrucksperre ist nach §95a UrhG verboten.

Mehr Informationen unter www.politiker-stopp.de.