Key result
Wavelet and Fourier analysis effectively estimated atrial fibrillatory rate from surface ECGs, showing a significant decrease in dominant frequency after right pulmonary vein isolation (P<0.05).
Why the study?
Does pulmonary vein isolation alter the dominant frequency of atrial fibrillation as measured by surface and intracardiac electrograms?
Observational (n=21)
Does pulmonary vein isolation alter the dominant frequency of atrial fibrillation as measured by surface and intracardiac electrograms?
p-value: p=< 0.05
Wavelet and Fourier analysis of surface ECG lead V1 can reliably estimate atrial fibrillatory rate, which decreases significantly following right pulmonary vein isolation.
Noninvasive ECG analysis may track AF rate changes after RPVI; extends intracardiac observations but remains hypothesis-generating.
AIMS: Frequency analysis of atrial electrograms from patients diagnosed with persistent atrial fibrillation (AF) appears to be crucial in its clinical diagnosis. This work explores the fibrillatory frequency properties of both surface and intracardiac electrograms before and after pulmonary vein isolation (PVI) using three time-frequency techniques. METHODS AND RESULTS: Surface electrocardiograms (ECGs) of 21 patients diagnosed with persistent AF undergoing PVI were recorded. Three methods, Fourier, ensemble average, and wavelet analysis, were used to identify the dominant frequency (DF) in surface ECGs. Dominant frequency was also computed in electrograms recorded within the coronary sinus (CS). Dominant frequency measured within the CS was best estimated in surface lead V1 using both Fourier (relative error: 10.94 ± 10.37%, correlation: 0.58) and wavelet analysis (relative error: 10.97 ± 11.08%, correlation: 0.53). Ensemble average gave highest relative error (21.29 ± 18.07%) and lowest correlation (0.10). Dominant frequency decreased after right PVI. This decrease was significant (P< 0.05) in most of the patients (13, 14, and 7 out of 14 when Fourier, wavelets, and ensemble average was used; 14 in CS). Further isolation of the left pulmonary veins (PVs) yielded a significant (P< 0.05) decrease in only a few of them (3, 4, and 2 out of 14 when Fourier, wavelets, and ensemble average was used; 4 in CS). CONCLUSION: Wavelet and Fourier analysis are good tools for estimating the atrial fibrillatory rate from surface ECG. A drop was observed in the DF value after isolation of the right PV. However, after left PVI this decrease was smaller.
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Romero et al. (2011) conducted an observational in persistent atrial fibrillation (n=21). Pulmonary vein isolation vs. Before pulmonary vein isolation was evaluated on Dominant frequency in surface and intracardiac electrograms (p=< 0.05). Wavelet and Fourier analysis effectively estimated atrial fibrillatory rate from surface ECGs, showing a significant decrease in dominant frequency after right pulmonary vein isolation (P<0.05).
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