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  4. A single-beat algorithm to discriminate farfield from nearfield bipolar voltage electrograms from the pulmonary veins
 
research article

A single-beat algorithm to discriminate farfield from nearfield bipolar voltage electrograms from the pulmonary veins

Schlageter, Vincent  
•
Badertscher, Patrick
•
Luca, Adrian  
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April 4, 2023
Journal Of Interventional Cardiac Electrophysiology

Background Superimposition of farfield (FF) and nearfield (NF) bipolar voltage electrograms (BVE) complicates the confirmation of pulmonary vein (PV) isolation after catheter ablation of atrial fibrillation. Our aim was to develop an automatic algorithm based on a single-beat analysis to discriminate PV NF from atrial FF BVE from a circular mapping catheter during the cryoballoon PV isolation.Methods During freezing cycles in cryoablation PVI, local NF and distant FF signals were recorded, identified and labelled. BVEs were classified using four different machine learning algorithms based on four frequency domain (high-frequency power (P-HF), low-frequency power (P-LF), relative high power band, P-HF ratio of neighbouring electrodes) and two time domain features (amplitude (V-max), slew rate). The algorithm-based classification was compared to the true identification gained during the PVI and to a classification by cardiac electrophysiologists.Results We included 335 BVEs from 57 consecutive patients. Using a single feature, P-HF with a cut-off at 150 Hz showed the best overall accuracy for classification (79.4%). By combining P-HF with V-max, overall accuracy was improved to 82.7% with a specificity of 89% and a sensitivity of 77%. The overall accuracy was highest for the right inferior PV (96.6%) and lowest for the left superior PV (76.9%). The algorithm showed comparable accuracy to the classification by the EP specialists.Conclusions An automated farfield-nearfield discrimination based on two simple features from a single-beat BVE is feasible with a high specificity and comparable accuracy to the assessment by experienced cardiac electrophysiologists.

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Type
research article
DOI
10.1007/s10840-023-01535-7
Web of Science ID

WOS:000964410900001

Author(s)
Schlageter, Vincent  
Badertscher, Patrick
Luca, Adrian  
Krisai, Philipp
Spies, Florian
Kueffer, Thomas
Osswald, Stefan
Vesin, Jean-Marc  
Kuehne, Michael
Sticherling, Christian
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Date Issued

2023-04-04

Publisher

SPRINGER

Published in
Journal Of Interventional Cardiac Electrophysiology
Subjects

Cardiac & Cardiovascular Systems

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Cardiovascular System & Cardiology

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nearfield

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farfield

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pulmonary vein isolation

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machine learning

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bipolar voltage electrogram

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automated verification

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atrial

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
SCI-STI-JMV  
Available on Infoscience
May 8, 2023
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/197476
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