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Preoperative study of the surface ECG for the prognosis of atrial fibrillation maze surgery outcome at discharge

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Preoperative study of the surface ECG for the prognosis of atrial fibrillation maze surgery outcome at discharge

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dc.contributor.author Hernández Alonso, Antonio es_ES
dc.contributor.author Alcaraz, Raul es_ES
dc.contributor.author Hornero, Fernando es_ES
dc.contributor.author Rieta, J J es_ES
dc.date.accessioned 2015-05-22T11:31:07Z
dc.date.available 2015-05-22T11:31:07Z
dc.date.issued 2014-07
dc.identifier.issn 0967-3334
dc.identifier.uri http://hdl.handle.net/10251/50700
dc.description.abstract The Cox-maze surgery is an effective procedure for terminating atrial fibrillation (AF) in patients requiring open-heart surgery associated with another heart disease. After the intervention, regardless of the patient's rhythm, all are treated with oral anticoagulants and antiarrhythmic drugs prior to discharge. Furthermore, patients maintaining AF before discharge could also be treated with electrical cardioversion (ECV). In view of this, a preoperative prognosis of the patient's rhythm at discharge would be helpful for optimizing drug therapy planning as well as for advancing ECV therapy. This work analyzes 30 preoperative electrocardiograms (ECGs) from patients suffering from AF in order to predict the Cox-maze surgery outcome at discharge. Two different characteristics of the AF pattern have been studied. On the one hand, the atrial activity (AA) organization, which provides information about the number of propagating wavelets in the atria, was investigated. AA organization has been successfully used in previous studies related to spontaneous reversion of paroxysmal AF and to the outcome of ECV. To assess organization, the dominant atrial frequency (DAF) and sample entropy (SampEn) have been computed. On the other hand, the second characteristic studied was the fibrillatory wave (f-wave) amplitude, which has been demonstrated to be a valuable indicator of the Cox-maze surgery outcome in previous studies. Moreover, this parameter has been obtained through a new methodology, based on computing the f-wave average power (fWP). Finally, all the computed indices were combined in a decision tree in order to improve prediction capability. Results for the DAF yielded a sensitivity (Se), a specificity (Sp) and an accuracy (Acc) of 61.54%, 82.35% and 73.33%, respectively. For SampEn the values were 69.23%, 76.00% and 73.33%, respectively, and for fWP they were 92.31%, 82.35% and 86.67%, respectively. Finally, the decision tree combining the three parameters analyzed improved the preoperative prognosis of the Cox-maze outcome with values of Se, Sp and Acc of 100%, 82.35% and 90%, respectively. As a consequence, the analysis of parameters related to the f-wave pattern, extracted from the preoperative ECG, has provided a considerable ability to predict the outcome of AF Cox-maze surgery at discharge. © 2014 Institute of Physics and Engineering in Medicine. es_ES
dc.description.sponsorship This work was supported by the projects TEC2010-20633 from the Spanish Ministry of Science and Innovation, TEC2013-41428-R from the Spanish Ministry of Economy and Competitiveness and PPII11-0194-8121 from Junta de Comunidades de Castilla La Mancha. en_EN
dc.language Inglés es_ES
dc.publisher IOP Publishing: Hybrid Open Access es_ES
dc.relation.ispartof Physiological Measurement es_ES
dc.rights Reserva de todos los derechos es_ES
dc.subject Electrocardiogram es_ES
dc.subject ECG es_ES
dc.subject Atrial fibrillation es_ES
dc.subject Cox-maze surgery es_ES
dc.subject Organization indices es_ES
dc.subject f-wave morphology es_ES
dc.subject.classification TECNOLOGIA ELECTRONICA es_ES
dc.title Preoperative study of the surface ECG for the prognosis of atrial fibrillation maze surgery outcome at discharge es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1088/0967-3334/35/7/1409
dc.relation.projectID info:eu-repo/grantAgreement/MICINN//TEC2010-20633/ES/DESARROLLO Y APLICACION DE ESTIMADORES AVANZADOS DE ORGANIZACION PARA LA CLASIFICACION TERAPEUTICA Y EL SEGUIMIENTO DE PACIENTES CON FIBRILACION AURICULAR/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/MINECO//TEC2013-41428-R/ES/APLICACION DE ANALISIS ELECTROCARDIOGRAFICO AVANZADO PARA LA EVALUACION CUANTITATIVA DEL REMODELADO ELECTROANATOMICO EN PACIENTES CON FIBRILACION AURICULAR/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/JCCM//PPII11-0194-8121/ es_ES
dc.rights.accessRights Cerrado es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica es_ES
dc.contributor.affiliation Universitat Politècnica de València. Grupo de ingeniería en bioseñales e imagen radiológica es_ES
dc.description.bibliographicCitation Hernández Alonso, A.; Alcaraz, R.; Hornero, F.; Rieta, JJ. (2014). Preoperative study of the surface ECG for the prognosis of atrial fibrillation maze surgery outcome at discharge. Physiological Measurement. 35(7):1409-1423. https://doi.org/10.1088/0967-3334/35/7/1409 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion http://dx.doi.org/10.1088/0967-3334/35/7/1409 es_ES
dc.description.upvformatpinicio 1409 es_ES
dc.description.upvformatpfin 1423 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 35 es_ES
dc.description.issue 7 es_ES
dc.relation.senia 285770
dc.contributor.funder Ministerio de Ciencia e Innovación es_ES
dc.contributor.funder Ministerio de Economía y Competitividad es_ES
dc.contributor.funder Junta de Comunidades de Castilla-La Mancha es_ES
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