Minimizing discordances in automated classification of fractionated electrograms in human persistent atrial fibrillation.
Ablation of persistent atrial fibrillation (persAF) targeting complex fractionated atrial electrograms (CFAEs) detected by automated algorithms has produced conflicting outcomes in previous electrophysiological studies. We hypothesize that the differences in these algorithms could lead to discordant...
| Publicado en: | Medical & Biological Engineering & Computing Vol. 54; no. 11; pp. 1695 - 1707 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Nov2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118887923&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118887923 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01400118 PO0 jtl: Medical & Biological Engineering & Computing issn: 01400118 maglogo: N pubinfo: dt: Nov2016 vid: 54 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 118887923 118887923 NLM26914407 10.1007/s11517-016-1456-2 NLM26914407 118887923 ppf: 1695 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Minimizing discordances in automated classification of fractionated electrograms in human persistent atrial fibrillation. aug: au: Almeida, Tiago Chu, Gavin Salinet, João Vanheusden, Frederique Li, Xin Tuan, Jiun Stafford, Peter Ng, G. Schlindwein, Fernando Almeida, Tiago P Chu, Gavin S Salinet, João L Vanheusden, Frederique J Tuan, Jiun H Stafford, Peter J Ng, G André Schlindwein, Fernando S affil: Department of Engineering , University of Leicester , University Road Leicester LE1 7RH UK sug: subj: Atrial Fibrillation Diagnosis Algorithms Heart Function Tests Male Sensitivity and Specificity Middle Age Female Reproducibility of Results ROC Curve Aged Automation Scales Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Ablation of persistent atrial fibrillation (persAF) targeting complex fractionated atrial electrograms (CFAEs) detected by automated algorithms has produced conflicting outcomes in previous electrophysiological studies. We hypothesize that the differences in these algorithms could lead to discordant CFAE classifications by the available mapping systems, giving rise to potential disparities in CFAE-guided ablation. This study reports the results of a head-to-head comparison of CFAE detection performed by NavX (St. Jude Medical) versus CARTO (Biosense Webster) on the same bipolar electrogram data (797 electrograms) from 18 persAF patients. We propose revised thresholds for both primary and complementary indices to minimize the differences in CFAE classification performed by either system. Using the default thresholds [NavX: CFE-Mean ≤ 120 ms; CARTO: ICL ≥ 7], NavX classified 70 % of the electrograms as CFAEs, while CARTO detected 36 % (Cohen's kappa κ ≈ 0.3, P < 0.0001). Using revised thresholds found using receiver operating characteristic curves [NavX: CFE-Mean ≤ 84 ms, CFE-SD ≤ 47 ms; CARTO: ICL ≥ 4, ACI ≤ 82 ms, SCI ≤ 58 ms], NavX classified 45 %, while CARTO detected 42 % (κ ≈ 0.5, P < 0.0001). Our results show that CFAE target identification is dependent on the system and thresholds used by the electrophysiological study. The thresholds found in this work counterbalance the differences in automated CFAE classification performed by each system. This could facilitate comparisons of CFAE ablation outcomes guided by either NavX or CARTO in future works. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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