Open AccessSpectral Analysis of Electrocardiograms in Patients with Inducible Atrial Fibrillation after Catheter Ablation Predicts Sinus Rhythm Maintenance
Author(s) -
Stavrakis Stavros,
Dyer John W.,
Scherlag Benjamin J.,
Khan Zeeshan,
Yeung Paul,
Chohan Jawad,
Po Sunny S.
Publication year - 2017
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12369
Subject(s) - medicine , interquartile range , atrial fibrillation , ablation , cardiology , catheter ablation , receiver operating characteristic , sinus rhythm , pulmonary vein , confidence interval , area under the curve
Background We aimed to develop a novel predictive marker for atrial fibrillation (AF) recurrence in patients with inducible AF after catheter ablation, based on power spectral analysis of baseline and postablation electrocardiograms. Methods Twenty‐five patients who had undergone their first AF ablation procedure (pulmonary vein isolation and ganglionated plexi ablation) and had inducible AF after ablation were included. A 30‐second interval of AF was chosen for each patient before and after ablation, and a periodogram of the atrial activity was computed. A ratio of the power in the dominant frequency to the power in the remainder of the periodogram (DFR) was calculated. Results Eight (32%) patients had recurrent AF at 1 year. The clinical and echocardiographic characteristics of patients with and without recurrence were similar (P > 0.05). After ablation, there was organization of atrial activity, evidenced by an increase in the DFR (0.28 ± 0.22 vs 0.53 ± 0.29; P = 0.001). The percent change in DFR before and after ablation (median [interquartile range]) was significantly higher in patients without AF recurrence (120% [30% to 344%] vs 3% [−27% to 66%]; P = 0.01). Receiver operating curve (ROC) analysis demonstrated that a less than 16% increase in DFR postablation was able to predict recurrence of AF (area under ROC curve = 0.82; P = 0.03) with 75% sensitivity and 94% specificity. Conclusion AF ablation leads to variable organization of atrial activity. Organization of atrial activity after AF ablation is associated with lower 1‐year recurrence rates and may be used intraprocedurally after as a novel end point for AF ablation. Larger prospective studies are warranted.