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Lookup NU author(s): Dr Luigi Di Marco, Dr Daniel Raine, Dr John Bourke, Dr Philip Langley
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Background: Non-invasive tools to help identify patients likely to benefit from catheter ablation (CA) of atrial fibrillation (AF) would facilitate personalised treatment planning. Aim: To investigate atrial waveform organisation through recurrence plot indices (RPI) and their ability to predict CA outcome.Methods: One minute 12-lead ECG was recorded before CA from 62 patients with AF (32 paroxysmal AF; 45 men; age 57 +/- 10 years). Organisation of atrial waveforms from i) TQ intervals in V-1 and ii) QRST suppressed continuous AF waveforms (CAFW), were quantified using RPI: percentage recurrence (PR), percentage determinism (PD), entropy of recurrence (ER). Ability to predict acute (terminating vs. non-terminating AF), 3-month and 6-month postoperative outcome (AF vs. AF free) were assessed.Results: RPI either by TQ or CAFW analysis did not change significantly with acute outcome. Patients arrhythmia-free at 6-month follow-up had higher organisation in TQ intervals by PD (p < 0.05) and ER (p < 0.005) and both were significant predictors of 6-month outcome (PD (AUC = 0.67, p < 0.05) and ER (AUC = 0.72, p < 0.005)). For paroxysmal AF cases, all RPI predicted 3-month (AUC(ER) = 0.78, p < 0.05; AUC(PD) = 0.79, p < 0.05; AUC(PR) = 0.80, p < 0.01) and 6-month (AUC(ER) = 0.81, p < 0.005: AUC(PD) = 0.75, p < 0.05; AUC(PR) = 0.71, p < 0.05) outcome. CAFW-derived RPIs did not predict acute or postoperative outcomes.Higher values of any RPI from TQ (values greater than 25th percentile of preoperative distribution) were associated with decreased risk of AF relapse at follow-up (hazard ratio <= 0.52, all p < 0.05).Conclusions: Recurring patterns from preprocedural 1-minute recordings of ECG TQ intervals were significant predictors of CA 6-month outcome. (C) 2014 Elsevier Ltd. All rights reserved.
Author(s): Di Marco LY, Raine D, Bourke JP, Langley P
Publication type: Article
Publication status: Published
Journal: Computers in Biology and Medicine
Year: 2014
Volume: 54
Pages: 172-179
Print publication date: 01/11/2014
Online publication date: 21/09/2014
Acceptance date: 12/09/2014
ISSN (print): 0010-4825
ISSN (electronic): 1879-0534
Publisher: PERGAMON-ELSEVIER SCIENCE LTD
URL: http://dx.doi.org/10.1016/j.compbiomed.2014.09.005
DOI: 10.1016/j.compbiomed.2014.09.005
PubMed id: 25282707
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