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  4. Nonlinear analysis of right atrial electrograms predicts termination of persistent atrial fibrillation within the left atrium by catheter ablation
 
research article

Nonlinear analysis of right atrial electrograms predicts termination of persistent atrial fibrillation within the left atrium by catheter ablation

Luca, Adrian  
•
Buttu, Andréa  
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Pruvot, Etienne
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2016
Physiological Measurement

The termination of long-standing persistent atrial fibrillation (LS-pAF) can be achieved by stepwise catheter ablation (step-CA) within the left atrium (LA). Our study aims to applying complexity measures derived from nonlinear time series analysis in order to characterize LS-pAF in terms of organization and to identify patients in whom AF can be terminated from those in whom AF cannot be terminated by step-CA within the LA. A total of 33 consecutive patients (age 61  ±  7 years, sustained AF duration 19  ±  11 months) with LS-pAF underwent step-CA. The organization of right bipolar electrograms before and during the ablation procedure was assessed using the coarse-grained correlation dimension. LS-pAF was terminated into sinus rhythm or atrial tachycardia in 22 patients during step-CA within the LA (left terminated patients—LT). In 11 patients the ablation procedure failed to terminate AF within LA (not left terminated patients—NLT). The statistical analysis of the estimated coarse-grained correlation dimension revealed that a higher right atrial (RA) organization before step-CA was associated to AF termination within the LA. During the ablation procedure, the level of RA organization displayed distinctive evolution between LT and NLT patients with a significant organization increase before AF termination for the LT patients.

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