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Clinical and heart rate variability feature analysis of pre-ablation AF patients leading to recurrence
Background Ablation has become a widespread treatment option for patients with Atrial Fibrillation (AF). However, a significant number of patients show recurrence within 12 months. This study aims to compare patients with and without post ablation recurrence, determining the best features extracted...
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Published in: | Journal of electrocardiology 2021-11, Vol.69, p.84-84 |
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description | Background Ablation has become a widespread treatment option for patients with Atrial Fibrillation (AF). However, a significant number of patients show recurrence within 12 months. This study aims to compare patients with and without post ablation recurrence, determining the best features extracted from RR intervals of the 500 beats preceding the patient's most recent AF episode as well as some clinical features. Methods The RR intervals from 92 AF patients (56.3 ± 10.9 years, M 72%) before ablation were extracted from and recorded by an Insertable Cardiac Monitoring (ICM) system. Classical Heart Rate Variability (HRV) features were then computed including Mean, pNN50, pNN20, RMSSD, SDNN, TINN, TRI, Approximate and Sample Entropy, SD1, SD2 and SD1SD2 ratio, and Detrended Fluctuation Analysis, Alphal and AJpha2. Potentially clinically relevant parameters such as AF type (Paroxysmal or Persistent) and lesion type (PVI only or PVI plus extra lesions) were also extracted. Two classes of patients, those with Recurrence, defined as existence of a recorded AF episode after a 3 months blanking period, and those with No Recurrence, were compared (Student's r-test for the numerical features and Pearson's chi-squared test for the categorical features). Results Out of the 92 patients that underwent the ablation, 43 (47%) were classed as No Recurrence and 49 (53%) as Recurrence. The extracted numerical features that were significantly different between the 2 groups (p-value |
doi_str_mv | 10.1016/j.jelectrocard.2021.11.012 |
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However, a significant number of patients show recurrence within 12 months. This study aims to compare patients with and without post ablation recurrence, determining the best features extracted from RR intervals of the 500 beats preceding the patient's most recent AF episode as well as some clinical features. Methods The RR intervals from 92 AF patients (56.3 ± 10.9 years, M 72%) before ablation were extracted from and recorded by an Insertable Cardiac Monitoring (ICM) system. Classical Heart Rate Variability (HRV) features were then computed including Mean, pNN50, pNN20, RMSSD, SDNN, TINN, TRI, Approximate and Sample Entropy, SD1, SD2 and SD1SD2 ratio, and Detrended Fluctuation Analysis, Alphal and AJpha2. Potentially clinically relevant parameters such as AF type (Paroxysmal or Persistent) and lesion type (PVI only or PVI plus extra lesions) were also extracted. Two classes of patients, those with Recurrence, defined as existence of a recorded AF episode after a 3 months blanking period, and those with No Recurrence, were compared (Student's r-test for the numerical features and Pearson's chi-squared test for the categorical features). Results Out of the 92 patients that underwent the ablation, 43 (47%) were classed as No Recurrence and 49 (53%) as Recurrence. The extracted numerical features that were significantly different between the 2 groups (p-value<:0.05) were pNN50 and pNN20. For the categorical features, the study highlights that PVI plus extra lesions lead to 60% of Recurrences. In addition, patients with Persistent AF had higher Recurrence (68%) than patients with Paroxysmal AF (49%). The chi-square test showed no significant differences for the categorical features. Conclusions Classical HRV features: pNN50 and pNN20, proved to be valuable features to be considered. The results concerning the patients with extra lesions lead us to the hypothesis that extra damage resulting on a stiffer left atrium with more scar tissue could favor the AF sustenance mechanisms, therefore increasing the chance of Recurrence. However, further analysis should be made as the test yielded a non-significant difference possibly due to having a small patient population (23 patients).</description><identifier>ISSN: 0022-0736</identifier><identifier>EISSN: 1532-8430</identifier><identifier>DOI: 10.1016/j.jelectrocard.2021.11.012</identifier><language>eng</language><publisher>New York: Elsevier Inc</publisher><subject>Ablation ; Cardiac arrhythmia ; Heart rate</subject><ispartof>Journal of electrocardiology, 2021-11, Vol.69, p.84-84</ispartof><rights>2021</rights><rights>Copyright Elsevier Science Ltd. Nov/Dec 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Saiz-Vivo, Javier</creatorcontrib><creatorcontrib>Corino, Valentina D.A.</creatorcontrib><creatorcontrib>de Melis, Mirko</creatorcontrib><creatorcontrib>Mainardi, Luca T.</creatorcontrib><title>Clinical and heart rate variability feature analysis of pre-ablation AF patients leading to recurrence</title><title>Journal of electrocardiology</title><description>Background Ablation has become a widespread treatment option for patients with Atrial Fibrillation (AF). However, a significant number of patients show recurrence within 12 months. This study aims to compare patients with and without post ablation recurrence, determining the best features extracted from RR intervals of the 500 beats preceding the patient's most recent AF episode as well as some clinical features. Methods The RR intervals from 92 AF patients (56.3 ± 10.9 years, M 72%) before ablation were extracted from and recorded by an Insertable Cardiac Monitoring (ICM) system. Classical Heart Rate Variability (HRV) features were then computed including Mean, pNN50, pNN20, RMSSD, SDNN, TINN, TRI, Approximate and Sample Entropy, SD1, SD2 and SD1SD2 ratio, and Detrended Fluctuation Analysis, Alphal and AJpha2. Potentially clinically relevant parameters such as AF type (Paroxysmal or Persistent) and lesion type (PVI only or PVI plus extra lesions) were also extracted. Two classes of patients, those with Recurrence, defined as existence of a recorded AF episode after a 3 months blanking period, and those with No Recurrence, were compared (Student's r-test for the numerical features and Pearson's chi-squared test for the categorical features). Results Out of the 92 patients that underwent the ablation, 43 (47%) were classed as No Recurrence and 49 (53%) as Recurrence. The extracted numerical features that were significantly different between the 2 groups (p-value<:0.05) were pNN50 and pNN20. For the categorical features, the study highlights that PVI plus extra lesions lead to 60% of Recurrences. In addition, patients with Persistent AF had higher Recurrence (68%) than patients with Paroxysmal AF (49%). The chi-square test showed no significant differences for the categorical features. Conclusions Classical HRV features: pNN50 and pNN20, proved to be valuable features to be considered. The results concerning the patients with extra lesions lead us to the hypothesis that extra damage resulting on a stiffer left atrium with more scar tissue could favor the AF sustenance mechanisms, therefore increasing the chance of Recurrence. However, further analysis should be made as the test yielded a non-significant difference possibly due to having a small patient population (23 patients).</description><subject>Ablation</subject><subject>Cardiac arrhythmia</subject><subject>Heart rate</subject><issn>0022-0736</issn><issn>1532-8430</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqNkEtv2zAQhIkiBeIk_Q9Eepa6S8p69Ba4zQMIkEtyJtbUMqWgSO6SDuB_HxnOoceedg4zg51PqWuEEgHrH0M58Mg-y-xJ-tKAwRKxBDRf1ArX1hRtZeFMrQCMKaCx9bm6SGkAgM40ZqXCZoxT9DRqmnr9h0myFsqs30kibeMY80EHprwXXiw0HlJMeg56J1zQdqQc50nf3OrdonjKSY9MfZxedZ61sN-L8OT5Sn0NNCb-9nkv1cvt7-fNffH4dPewuXksPFZgC-7adRM6rLcdNm0XaiAKfQvcG7BV5ZuA1q8NhqalzoaqD4a9aRtqupq3Bu2l-n7q3cn8d88pu2Hey_J2cqbGDg2CtYvr58nlZU5JOLidxDeSg0NwR65ucP9ydUeuDtEtXJfwr1OYlx3vkcUlH48b-7jsza6f4__UfAC4bYie</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Saiz-Vivo, Javier</creator><creator>Corino, Valentina D.A.</creator><creator>de Melis, Mirko</creator><creator>Mainardi, Luca T.</creator><general>Elsevier Inc</general><general>Elsevier Science Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope></search><sort><creationdate>202111</creationdate><title>Clinical and heart rate variability feature analysis of pre-ablation AF patients leading to recurrence</title><author>Saiz-Vivo, Javier ; Corino, Valentina D.A. ; de Melis, Mirko ; Mainardi, Luca T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1403-e9857f916b91789f60aafd80ed20344c7f13c521f78a93f4df2ec287a796eb213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Ablation</topic><topic>Cardiac arrhythmia</topic><topic>Heart rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saiz-Vivo, Javier</creatorcontrib><creatorcontrib>Corino, Valentina D.A.</creatorcontrib><creatorcontrib>de Melis, Mirko</creatorcontrib><creatorcontrib>Mainardi, Luca T.</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Journal of electrocardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saiz-Vivo, Javier</au><au>Corino, Valentina D.A.</au><au>de Melis, Mirko</au><au>Mainardi, Luca T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and heart rate variability feature analysis of pre-ablation AF patients leading to recurrence</atitle><jtitle>Journal of electrocardiology</jtitle><date>2021-11</date><risdate>2021</risdate><volume>69</volume><spage>84</spage><epage>84</epage><pages>84-84</pages><issn>0022-0736</issn><eissn>1532-8430</eissn><abstract>Background Ablation has become a widespread treatment option for patients with Atrial Fibrillation (AF). However, a significant number of patients show recurrence within 12 months. This study aims to compare patients with and without post ablation recurrence, determining the best features extracted from RR intervals of the 500 beats preceding the patient's most recent AF episode as well as some clinical features. Methods The RR intervals from 92 AF patients (56.3 ± 10.9 years, M 72%) before ablation were extracted from and recorded by an Insertable Cardiac Monitoring (ICM) system. Classical Heart Rate Variability (HRV) features were then computed including Mean, pNN50, pNN20, RMSSD, SDNN, TINN, TRI, Approximate and Sample Entropy, SD1, SD2 and SD1SD2 ratio, and Detrended Fluctuation Analysis, Alphal and AJpha2. Potentially clinically relevant parameters such as AF type (Paroxysmal or Persistent) and lesion type (PVI only or PVI plus extra lesions) were also extracted. Two classes of patients, those with Recurrence, defined as existence of a recorded AF episode after a 3 months blanking period, and those with No Recurrence, were compared (Student's r-test for the numerical features and Pearson's chi-squared test for the categorical features). Results Out of the 92 patients that underwent the ablation, 43 (47%) were classed as No Recurrence and 49 (53%) as Recurrence. The extracted numerical features that were significantly different between the 2 groups (p-value<:0.05) were pNN50 and pNN20. For the categorical features, the study highlights that PVI plus extra lesions lead to 60% of Recurrences. In addition, patients with Persistent AF had higher Recurrence (68%) than patients with Paroxysmal AF (49%). The chi-square test showed no significant differences for the categorical features. Conclusions Classical HRV features: pNN50 and pNN20, proved to be valuable features to be considered. The results concerning the patients with extra lesions lead us to the hypothesis that extra damage resulting on a stiffer left atrium with more scar tissue could favor the AF sustenance mechanisms, therefore increasing the chance of Recurrence. However, further analysis should be made as the test yielded a non-significant difference possibly due to having a small patient population (23 patients).</abstract><cop>New York</cop><pub>Elsevier Inc</pub><doi>10.1016/j.jelectrocard.2021.11.012</doi><tpages>1</tpages></addata></record> |
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subjects | Ablation Cardiac arrhythmia Heart rate |
title | Clinical and heart rate variability feature analysis of pre-ablation AF patients leading to recurrence |
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