Key result
Having the highest temporally stable pseudo-frequency inside the pulmonary veins was associated with a significantly higher ablation success rate compared to non-PV sites (90% vs. 62%, P=0.023).
Why the study?
Does the location of the highest temporally stable pseudo-frequency (sPF) predict ablation success in patients with persistent AF undergoing PVI?
Cohort (n=44)
Does the location of the highest temporally stable pseudo-frequency (sPF) predict ablation success in patients with persistent AF undergoing PVI?
Absolute Event Rate: 90% vs 62%
p-value: p=0.023
Continuous wavelet transform analysis during AF can identify patients with highest temporally stable pseudo-frequency inside the PVs, who have significantly better outcomes with PVI alone compared to those with highest sPF at non-PV sites.
Highest sPF in PVs was associated with higher PVI success in persistent AF; leaves open whether non-PV targeting improves outcomes.
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.
No takes yet. Share an insight, caveat, or question.
Kimata et al. (2018) conducted a cohort in persistent atrial fibrillation (n=44). Highest temporally stable pseudo-frequency (sPF) inside pulmonary veins vs. Highest sPF at non-PV sites was evaluated on Ablation success rate (p=0.023). Having the highest temporally stable pseudo-frequency inside the pulmonary veins was associated with a significantly higher ablation success rate compared to non-PV sites (90% vs. 62%, P=0.023).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: