Novel Time-Frequency Features of the Fibrillatory Waves Improve Catheter Ablation Outcome Prediction of Persistent Atrial Fibrillation

Abstract

[EN] Despite its limited long-term success rate, catheter ablation (CA) is still the first-line treatment for patients suffering from persistent atrial fibrillation (AF). Preoperative prediction on the procedure¿s outcome is gaining clinical interest to provide optimized patient selection, limit repeated procedures, hospitalization rates, and treatment costs. To this respect, dominant frequency (DF) and amplitude of fibrillatory waves (f-waves) reflected on the electrocardiogram (ECG) recording have provided promising results. Hence, this work explores the ability of a novel set of frequency and amplitude features of the f-waves to improve CA outcome prediction. More precisely, in addition to DF and normalized f-wave amplitude (NFWA), three indices such as spectral entropy (SE), spectral flatness measure (SFM), and amplitude spectrum area (AMSA) were also analyzed. The results obtained for 204 6 s-length ECG intervals extracted from 51 persistent AF patients showed that all indices found statistically significant differences between the patients who maintained sinus rhythm and those who relapsed to AF after a follow-up of 9 months. However, they only obtained limited a discriminant ability ranging between 55 and 62%, which was overcome by 15¿23% when NFWA, SE and AMSA were combined. Consequently, this combination of frequency and amplitude features of the f-waves seems to provide new insights about the atrial substrate remodeling, which could be helpful in improving preoperative CA outcome prediction. Nonetheless, further studies are required in the future