Frequency analysis of surface electrocardiograms (ECGs) in patients with persistent atrial fibrillation: Correlation with the intracardiac ECGs and implications for radiofrequency catheter ablation

• Published in: Journal of arrhythmia 2014-12, Vol.30 (6), p.453-459
• Main Authors: Uetake, Shunsuke, MD, Miyauchi, Yasushi, MD, Osaka, Motohisa, MD, Hayashi, Meiso, MD, Iwasaki, Yu-ki, MD, Yodogawa, Kenji, MD, Horie, Tsutomu, MD, Tsuboi, Ippei, MD, Hayashi, Hiroshi, MD, Takahashi, Kenta, MD, Shimizu, Wataru, MD
• Format: Article
• Language: English
• Subjects: Ablation; Ablation (Surgery); Algorithms; Analysis; Antiarrhythmics; Anticoagulants; Atrial fibrillation; Cardiac arrhythmia; Cardiovascular; Care and treatment; Catheters; Dominant frequency; Electrocardiogram; Electrocardiography; f-wave; Fast Fourier transform; Fourier transforms; Patients; QRS-T subtraction; Signal processing; Variables
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1016/j.joa.2013.12.003

Abstract Background The nature and significance of the frequency characteristics of the surface electrocardiogram (ECG) in patients with persistent atrial fibrillation (AF) undergoing radiofrequency ablation are unclear. Methods Preablation surface and intracardiac ECGs were obtained using offline fast Fourier transform (FFT) analysis in 40 patients with persistent AF. For the FFT analysis of the surface f-wave, the QRS-T complex was canceled utilizing a template subtraction algorithm. The ablation procedure included isolation of the pulmonary veins (PV) and posterior left atrium and linear ablation of the mitral isthmus and additional lesions using a stepwise approach. Results The dominant frequency (DF) of all the intracardiac signals, except for the left inferior PV, had a significant correlation with the DFs from the surface electrocardiogram. The strongest correlation was observed between the DFs of the left atrial appendage (LAA) and those on the limb leads (correlation coefficient, 0.802–0.882, P