Automated Detection of Complex Fractionated Atrial Electrograms In Substrate-Based Atrial Fibrillation Ablation: Better Discrimination with a New Setting of CARTO® Algorithm.

Q: What does this research mean for the field?

A customized setting for the CARTO® CFAE algorithm provides significantly better selectivity than the nominal setting, enabling automated detection of complex fractionated atrial electrograms involved in atrial fibrillation perpetuation that closely matches expert visual analysis. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Julien Seitz; Jérôme Horvilleur; Jérôme Lacotte; Yamina Mouhoub; Fiorella Salerno; Anouska Moynagh; Darach O h-Icí; Mehran Monchi; Laurence Curel; André Pisapia

doi:10.4022/jafib.673

August 31, 2013

Automated Detection of Complex Fractionated Atrial Electrograms In Substrate-Based Atrial Fibrillation Ablation: Better Discrimination with a New Setting of CARTO® Algorithm.

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Why the study?

Does a customized CARTO SCI algorithm setting improve the selectivity of automated CFAE detection compared to the nominal setting in patients undergoing AF ablation?

Structured PICO

Does a customized CARTO SCI algorithm setting improve the selectivity of automated CFAE detection compared to the nominal setting in patients undergoing AF ablation?

P

Population

32 patients (75% male, mean age 60.4 ± 12.7 years) undergoing radiofrequency catheter ablation for paroxysmal (n=3), persistent (n=16), or long-standing persistent (n=13) atrial fibrillation, with a long history of AF (mean 79±64 months).

I

Intervention

Customized CARTO shortest complex interval (SCI) algorithm setting (SCI 30-40ms/0.04-0.15mV) for automated detection of complex fractionated atrial electrograms (CFAE).

C

Comparator

Nominal CARTO SCI algorithm setting (SCI 60-120ms/0.05-0.15mV).

O

Outcome

Selectivity of CFAE detection, measured by CFAE-CARTO surface area and the proportion of ablated areas within detected CFAE-CARTO areas compared to operator's visual analysis.surrogate

A customized CARTO algorithm setting (SCI 30-40) significantly improves the selectivity of automated CFAE detection, aligning more closely with experienced operators' visual analysis during AF ablation.

Limitations

Retrospective design of the study
Low-density LA maps requiring point interpolation
Assumption of temporal stability of CFAE with a 2.5 sec window of acquisition
Each RF application considered as a fixed 60 mm² diameter circle

Implication

Customized CARTO settings may enhance CFAE selectivity in AF ablation; hypothesis-generating and should not yet change practice.

Abstract

This new customized CFAE algorithm setting is significantly more selective than the nominal one and allows an automated detection of CFAE really involved in AF perpetuation truer to an efficient experienced operator's electrogram visual analysis.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Seitz et al. (2013) studied this question.

synapsesocial.com/papers/6a1b8ee9950e49a3ca0c853b https://doi.org/10.4022/jafib.673

Topics

Atrial fibrillation

Persistent AF management

AF ablation outcomes

Anticoagulation in AF

View Full Paper

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Automated Detection of Complex Fractionated Atrial Electrograms In Substrate-Based Atrial Fibrillation Ablation: Better Discrimination with a New Setting of CARTO® Algorithm.

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Automated Detection of Complex Fractionated Atrial Electrograms In Substrate-Based Atrial Fibrillation Ablation: Better Discrimination with a New Setting of CARTO® Algorithm.

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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