Combination of frequency- and time-domain characteristics of the fibrillatory waves for enhanced prediction of persistent atrial fibrillation recurrence after catheter ablation.

Autor:	Escribano P; Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Albacete, Spain., Ródenas J; Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Albacete, Spain., García M; Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Albacete, Spain., Arias MA; Cardiac Arrhythmia Department, Complejo Hospitalario Universitario de Toledo, Toledo, Spain., Hidalgo VM; Cardiac Arrhythmia Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain., Calero S; Cardiac Arrhythmia Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain., Rieta JJ; BioMIT.org, Electronic Engineering Department, Universitat Politecnica de Valencia, Valencia, Spain., Alcaraz R; Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Albacete, Spain.
Jazyk:	angličtina
Zdroj:	Heliyon [Heliyon] 2024 Jan 30; Vol. 10 (3), pp. e25295. Date of Electronic Publication: 2024 Jan 30 (Print Publication: 2024).
DOI:	10.1016/j.heliyon.2024.e25295
Abstrakt:	Catheter ablation (CA) remains the cornerstone alternative to cardioversion for sinus rhythm (SR) restoration in patients with atrial fibrillation (AF). Unfortunately, despite the last methodological and technological advances, this procedure is not consistently effective in treating persistent AF. Beyond introducing new indices to characterize the fibrillatory waves ( f -waves) recorded through the preoperative electrocardiogram (ECG), the aim of this study is to combine frequency- and time-domain features to improve CA outcome prediction and optimize patient selection for the procedure, given the absence of any study that jointly analyzes information from both domains. Precisely, the f -waves of 151 persistent AF patients undergoing their first CA procedure were extracted from standard V1 lead. Novel spectral and amplitude features were derived from these waves and combined through a machine learning algorithm to anticipate the intervention mid-term outcome. The power rate index ( φ ), which estimates the power of the harmonic content regarding the dominant frequency (DF), yielded the maximum individual discriminant ability of 64% to discern between individuals who experienced a recurrence of AF and those who sustained SR after a 9-month follow-up period. The predictive accuracy was improved up to 78.5% when this parameter φ was merged with the amplitude spectrum area in the DF bandwidth ( A M S A L F ) and the normalized amplitude of the f -waves into a prediction model based on an ensemble classifier, built by random undersampling boosting of decision trees. This outcome suggests that the synthesis of both spectral and temporal features of the f -waves before CA might enrich the prognostic knowledge of this therapy for persistent AF patients. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors.)
Databáze:	MEDLINE
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