Temporally stable frequency mapping using continuous wavelet transform analysis in patients with persistent atrial fibrillation

被引:11
作者
Kimata, Akira [1 ,2 ]
Yokoyama, Yasuhiro [2 ]
Aita, Satoshi [1 ,2 ]
Nakamura, Hiroaki [2 ]
Higuchi, Koji [3 ]
Tanaka, Yasuaki [4 ]
Nogami, Akihiko [1 ]
Hirao, Kenzo [5 ]
Aonuma, Kazutaka [1 ]
机构
[1] Univ Tsukuba, Fac Med, Dept Cardiol, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
[2] St Luke Int Hosp, Dept Cardiol, Tokyo, Japan
[3] Hiratsuka Kyosai Hosp, Dept Cardiol, Hiratsuka, Kanagawa, Japan
[4] Yokosuka Kyosai Hosp, Dept Cardiol, Yokosuka, Kanagawa, Japan
[5] Tokyo Med & Dent Univ, Dept Cardiol, Tokyo, Japan
关键词
atrial fibrillation; catheter ablation; continuous wavelet transform; frequency analysis; mapping; CATHETER ABLATION; DOMINANT FREQUENCY; TRIAL; ARRHYTHMIAS; MECHANISMS; RHYTHM; SITES; HEART;
D O I
10.1111/jce.13440
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Dominant frequency (DF) derived from fast Fourier transform (FFT) analysis has failed to guide atrial fibrillation (AF) ablation since it cannot guarantee temporal stability. Continuous wavelet transform (CWT) analysis is another frequency analysis that can show the temporal stability of a frequency. Methods and results: Forty-four consecutive patients with persistent AF (PeAF) underwent pulmonary vein (PV) isolation (PVI) as the first-time catheter ablation. The PVs and left atrium were mapped and electrograms (EGMs) were recorded for 30 seconds at each site. Pseudo-frequency (PF) and coefficient of variation (CV) were calculated by CWT analysis. A PF with CV 10 was defined as a temporally stable PF (sPF). DF was also calculated by traditional FFT analysis from the first 5 seconds of the recorded EGMs. The highest sPF was shown inside the PVs in 20 patients (PV group), and at the non-PV sites in 24 patients (non-PV group). During the follow-up period of 15.3 +/- 4.4 months, the ablation success rate in the PV group was significantly higher than that in the non-PV group (90% vs. 62%, P = 0.023). The location of the highest DF did not have a significant effect on ablation success rate between inside the PVs and at the non-PV sites. Conclusion: PVI results for PeAF were significantly worse for patients with highest sPF at the non-PV sites compared to patients with highest sPF sites inside the PVs. CWT analysis during AF could be used to verify whether PVI alone is sufficient for the first-time catheter ablation in patients with PeAF.
引用
收藏
页码:514 / 522
页数:9
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