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  4. Evaluation and optimization of novel extraction algorithms for the automatic detection of atrial activations recorded within the pulmonary veins during atrial fibrillation
 
research article

Evaluation and optimization of novel extraction algorithms for the automatic detection of atrial activations recorded within the pulmonary veins during atrial fibrillation

Prudat, Yann  
•
Luca, Adrian  
•
Yazdani, Sasan  
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August 28, 2022
Bmc Medical Informatics And Decision Making

Background and objective The automated detection of atrial activations (AAs) recorded from intracardiac electrograms (IEGMs) during atrial fibrillation (AF) is challenging considering their various amplitudes, morphologies and cycle length. Activation time estimation is further complicated by the constant changes in the IEGM active zones in complex and/or fractionated signals. We propose a new method which provides reliable automatic extraction of intracardiac AAs recorded within the pulmonary veins during AF and an accurate estimation of their local activation times. Methods First, two recently developed algorithms were evaluated and optimized on 118 recordings of pulmonary vein IEGM taken from 35 patients undergoing ablation of persistent AF. The adaptive mathematical morphology algorithm (AMM) uses an adaptive structuring element to extract AAs based on their morphological features. The relative-energy algorithm (Rel-En) uses short- and long-term energies to enhance and detect the AAs in the IEGM signals. Second, following the AA extraction, the signal amplitude was weighted using statistics of the AA sequences in order to reduce over- and undersensing of the algorithms. The detection capacity of our algorithms was compared with manually annotated activations and with two previously developed algorithms based on the Teager-Kaiser energy operator and the AF cycle length iteration, respectively. Finally, a method based on the barycenter was developed to reduce artificial variations in the activation annotations of complex IEGM signals. Results The best detection was achieved using Rel-En, yielding a false negative rate of 0.76% and a false positive rate of only 0.12% (total error rate 0.88%) against expert annotation. The post-processing further reduced the total error rate of the Rel-En algorithm by 70% (yielding to a final total error rate of 0.28%). Conclusion The proposed method shows reliable detection and robust temporal annotation of AAs recorded within pulmonary veins in AF. The method has low computational cost and high robustness for automatic detection of AAs, which makes it a suitable approach for online use in a procedural context.

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Type
research article
DOI
10.1186/s12911-022-01969-5
Web of Science ID

WOS:000846789800001

Author(s)
Prudat, Yann  
Luca, Adrian  
Yazdani, Sasan  
Derval, Nicolas
Jais, Pierre
Roten, Laurent
Berte, Benjamin
Pruvot, Etienne
Vesin, Jean-Marc  
Pascale, Patrizio
Date Issued

2022-08-28

Publisher

BMC

Published in
Bmc Medical Informatics And Decision Making
Volume

22

Issue

1

Start page

225

Subjects

Medical Informatics

•

biomedical signal processing

•

non-linear signal processing

•

atrial fibrillation

•

intracardiac electrograms

•

activation detection

•

cycle length

•

electrograms

•

ablation

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
SCI-STI-JMV  
Available on Infoscience
September 12, 2022
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/190758
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