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Although catheter ablation (CA) is still the first-line treatment for persistent atrial fibrillation (AF) patients, its limited long-term success rate has motivated clinical interest in preoperative prediction on the procedure&#x0027;s outcome to provide optimized patient selection, limit repeated procedures, hospitalization rates, and treatment costs. To this respect, dominant frequency (DF) and amplitude of fibril-latory waves (f-waves) reflected on the ECG have provided promising results. Hence this work explores the ability of a novel set of frequency and amplitud f-waves features, such as spectral entropy (SE), spectral flatness measure (SFM), and amplitud spectrum area (AMSA), along with DF and normalized f-wave amplitude (NFWA), to improve CA outcome prediction. Despite all single indices reported statistically significant differences between patients who relapsed to AF and those who maintained sinus rhythm after a follow-up of 9 months for 204 6 s-length ECG intervals extracted from 51 persistent AF patients, they obtained a limited discriminant ability ranging between 55 and 62&#x0025;, which was overcome by 15-23&#x0025; 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.

Catheter Ablation Outcome Prediction With Advanced Time-Frequency Features of the Fibrillatory Waves From Patients in Persistent Atrial Fibrillation