Key result
The average AUROC of five atrial electrogram-derived markers for classifying coronary sinus cycle length changes reached a maximum of 0.60 at a threshold value of 10 ms.
Why the study?
Although AF cycle length changes are widely used as a ground truth for substrate modification during AF ablation, optimal thresholds for coronary sinus cycle length changes using AEG-derived markers needed evaluation.
What is the optimal threshold for changes in coronary sinus cycle length to assess the effect of substrate modification during persistent atrial fibrillation ablation using atrial electrogram-derived markers?
Observational (n=11)
No
What is the optimal threshold for changes in coronary sinus cycle length to assess the effect of substrate modification during persistent atrial fibrillation ablation using atrial electrogram-derived markers?
A 10 ms threshold for changes in coronary sinus cycle length is suggested as an optimal starting setpoint to identify persistent AF ablation targets based on objective electrophysiological ground truth.
Changes in atrial fibrillation cycle length (AF-CL) are broadly used as a 'ground truth' to assess the effect of substrate modification during AF ablation. This work sought to optimize thresholds for changes in coronary sinus CL (CS-CL) after local ablation using different atrial electrogram (AEG)-derived markers. 834 AEGs were collected from 11 patients undergoing persAF ablation. CS-CL was measured before and after each ablation point. Five AEG-derived markers were tested as classifiers for CS-CL changes: ICL (Biosense Webster), CFE-Mean (St. Jude Medical), Wave Similarity, Shannon Entropy and AEG-CL. The area under the receiver operating characteristic (AUROC) curve was used to assess the quality of classification for each marker. Maximum AUROC was found at threshold values between 9 and 14 ms in all markers, except for Shannon Entropy. The average AUROC of the five markers reached a maximum of 0.60 at a threshold value of 10 ms. The 10 ms threshold is suggested as a starting setpoint for future studies seeking to identify AF ablation targets based on an objective 'ground truth'.
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Bezerra et al. (2020) conducted an observational in Persistent Atrial Fibrillation (n=11). Atrial electrogram-derived markers (ICL, CFE-Mean, Wave Similarity, Shannon Entropy, AEG-CL) was evaluated on Area under the receiver operating characteristic (AUROC) curve for classifying coronary sinus cycle length changes. The average AUROC of five atrial electrogram-derived markers for classifying coronary sinus cycle length changes reached a maximum of 0.60 at a threshold value of 10 ms.
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