Discrimination of left atrial and pulmonary vein potentials in patients with paroxysmal atrial fibrillation.
Introduction: Ablation of muscular fascicles around the ostium of pulmonary veins (PVs) resulting in electrical isolation of the veins may prove to be an effective treatment for atrial fibrillation (AF). Correctly discriminating atrial and PV potentials is necessary to effectively isolate PVs from t...
| Published in: | Journal of Cardiovascular Electrophysiology Vol. 14; no. 7; pp. 698 - 705 |
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| Main Authors: | , , , , |
| Format: | clinical trial research Journal Article |
| Published: |
Wiley-Blackwell
Jul2003
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106023294&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106023294 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jul2003 vid: 14 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106023294 2009386265 10.1046/j.1540-8167.2003.03074.x NLM12930248 106023294 ppf: 698 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Discrimination of left atrial and pulmonary vein potentials in patients with paroxysmal atrial fibrillation. aug: au: Patel N Kay GN Sanchez J Ideker RE Smith WM sug: subj: Algorithms Atrial Fibrillation Diagnosis Atrial Fibrillation Physiopathology Electrocardiography Methods Heart Atrium Physiopathology Heart Conduction System Physiopathology Pulmonary Veins Physiopathology Adult Aged Atrial Fibrillation Classification Clinical Trials Diagnosis, Computer Assisted Methods Electrodes, Implanted Female Heart Atrium Innervation Heart Atrium Metabolism Male Middle Age Pulmonary Veins Innervation Recurrence Tachycardia Classification Tachycardia Diagnosis Tachycardia Physiopathology Human Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Introduction: Ablation of muscular fascicles around the ostium of pulmonary veins (PVs) resulting in electrical isolation of the veins may prove to be an effective treatment for atrial fibrillation (AF). Correctly discriminating atrial and PV potentials is necessary to effectively isolate PVs from the left atrium in patients with paroxysmal AF. Methods and Results: A training set of 151 electrode recordings obtained from 10 patients with AF was used to develop an algorithm to discriminate atrial and PV potentials. Bipolar electrograms were collected from a multielectrode basket catheter placed sequentially into each PV. Amplitude, slope, and normalized slopes of both bipolar and quadripolar electrograms (difference between adjacent bipoles) were entered into a binary logistic regression model. A receiver operating characteristic curve was used to define a threshold able to effectively discriminate atrial and PV potentials. The normalized slopes of both domains, bipolar and quadripolar, produced a logistic function that discriminated atrial and PV potentials against a threshold (0.38) with 97.8% sensitivity and 94.9% specificity. The algorithm then was evaluated on a test set of 214 electrode recordings from four patients who also had paroxysmal AF. These patient electrograms also were evaluated by two independent electrophysiologists. The algorithm and electrophysiologists matched identification of activation origin in 84% of electrograms. Conclusion: Atrial and PV potentials acquired from a multielectrode basket catheter can be discriminated using the normalized slopes of bipolar and quadripolar electrograms. These additional parameters need to be included by physicians determining the preferential ablation site within PVs. (J Cardiovasc Electrophysiol, Vol. 14, pp. 698-704, July 2003). pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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