Atrial Fibrillation Surgical Ablation Long-term Outcome Prediction Just with One Lead of the Preoperative Surface Electrocardiogram

Abstract

[EN] To revert atrial fibrillation (AF) in patients requiring concomitant open-heart surgery, surgical ablation (SA) is one of the most effective procedures. However, this intervention is as- sociated with major side effects. Considering this limitation together with the benefits of anticipating antiarrhythmic treatment decisions, preoperative prediction of long-term outcome of SA is an interesting challenge. In the present work a novel algorithm to anticipate SA outcome after a follow-up of 12 months is introduced by just analyzing one lead from a preoperative electrocardiogram (ECG). Precisely, fibrillatory waves reflected on lead V1 are extracted using a QRST cancellation method. The obtained signal is divided into 1 s-length segments, which are decomposed into 8 time scales by making use a Wavelet transform. Finally, relative wavelet energy for each segment and scale is computed and the standard deviation of the time series for the 7th scale is obtained as a measure of organization of the fibrillatory waves. This index obtained statistically significant differences between the patients who maintained sinus rhythm and relapsed to AF during the follow-up. Moreover, it also yielded a discriminant ability about 75%, thus improving between 13 and 29% the one showed by other well-established parameters.