Non-invasive 3D Electromechanical Cycle Length Mapping for Atrial Fibrillation Mapping and PVI Ablation Response Prediction

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Atrial Fibrillation (n=15). Intervention: Electromechanical Cycle Length Mapping (ECLM). Primary outcome: Atrial fibrillation recurrence within three months (AUC 0.81).

Q: What does this research mean for the field?

Pre-ablation electromechanical cycle length dispersion, measured via non-invasive Electromechanical Cycle Length Mapping (ECLM), independently predicts atrial fibrillation recurrence within three months following first-time ablation. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Melina Tourni; Seungyeon Julia Han; Mary Kucinski; Hannah Kim; Angelo Biviano; Elisa E. Konofagou

doi:10.1109/uffc-js60046.2024.10793722

September 22, 2024

Non-invasive 3D Electromechanical Cycle Length Mapping for Atrial Fibrillation Mapping and PVI Ablation Response Prediction

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Key result

Pre-ablation electromechanical cycle length dispersion strongly predicts AF recurrence within three months of first-time ablation.

AUC 0.81
n=15

Why the study?

Source-agnostic PVI success rates for first-time AF ablation remain 50-70%, prompting evaluation of noninvasive ECLM for mapping AF electromechanical cycle length and predicting ablation outcomes.

Does Electromechanical Cycle Length Mapping (ECLM) predict AF recurrence in patients undergoing first-time AF ablation?

Study Design

Type

Observational (n=15)

Structured PICO

Does Electromechanical Cycle Length Mapping (ECLM) predict AF recurrence in patients undergoing first-time AF ablation?

P

Population

15 patients with Atrial Fibrillation (AF) undergoing their first successful cardiac ablation

I

Intervention

Electromechanical Cycle Length Mapping (ECLM), a high-frame-rate, noninvasive 2D ultrasound technique, performed before and after ablation

O

Outcome

AF recurrence within three monthssurrogate

Main Result

Effect estimate: AUC 0.81

Pre-ablation Electromechanical Cycle Length Mapping (ECLM) can identify arrhythmic triggers and predict AF recurrence within three months after first-time ablation.

Implication

May aid pre-ablation risk stratification; leaves open whether ECLM improves outcomes in prospective trials.

Abstract

Source-agnostic pulmonary vein isolation (PVI) success rate for first-time Atrial Fibrillation (AF) ablation remains 50-70%, requiring additional procedures upon recurrence. This study investigates the potential of Electromechanical Cycle Length Mapping (ECLM), a high-frame-rate, noninvasive 2D ultrasound technique, for mapping and quantifying atrial fibrillation (AF) electromechanical cycle length (CL) activity, and its use in predicting long-term outcomes following ablation procedures. Fifteen AF patients were imaged before and after their first successful cardiac ablation. Pre-ablation ECLM maps accurately identified arrhythmic trigger locations in all patients, with a noticeable reduction post-ablation. During follow-up, seven patients experienced AF recurrence within three months. Pre-ablation CL dispersion was found to be an independent predictor of this recurrence (multivariate logistic regression, AUC = 0.81). These results highlight ECLM's potential for immediate arrhythmia assessment and predicting treatment response at the time of diagnosis.

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Cite This Study

Tourni et al. (2024) conducted an observational in Atrial Fibrillation (n=15). Electromechanical Cycle Length Mapping (ECLM) was evaluated on Atrial fibrillation recurrence within three months (AUC 0.81). Pre-ablation electromechanical cycle length dispersion independently predicted atrial fibrillation recurrence within three months following first-time ablation (AUC = 0.81).

synapsesocial.com/papers/6a15337aa4734e8e604e25cd https://doi.org/10.1109/uffc-js60046.2024.10793722