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Unsupervised Classification of Atrial Electrograms for Electroanatomic Mapping of Human Persistent Atrial Fibrillation
journal contribution
posted on 2020-09-28, 11:58 authored by Tiago Almeida, Diogo Soriano, Michela Mase, Flavia Ravelli, Arthur Bezerra, Xin Li, Gavin Chu, Joao Salinet, Peter Stafford, G Andre Ng, Fernando Schlindwein, Takashi YoneyamaObjective: Ablation treatment for persistent atrial fibrillation (persAF) remains challenging due to the absence of a "ground truth" for atrial substrate characterization and the presence of multiple mechanisms driving the arrhythmia. We implemented an unsupervised classification to identify AEG clusters with similar patterns, which were then validated by AEG-derived markers. Methods: 956 bipolar AEGs were collected from 11 persAF patients. CARTO variables (Biosense Webster; ICL, ACI and SCI) were used to create a 3D space, and subsequently used to perform an unsupervised classification with k-means. The characteristics of the identified groups were investigated using nine AEG-derived markers: sample entropy (SampEn), dominant frequency, organization index (OI), determinism, laminarity, recurrence rate (RR), peak-to-peak (PP) amplitude, cycle length (CL), and wave similarity (WS).
Results: Five AEG classes with distinct characteristics were identified (F=582, P<0.0001). The presence of fractionation increased from class 1 to 5, as reflected by the nine markers. Class 1 (25%) included organized AEGs with high WS, determinism, laminarity, and RR, and low SampEn. Class 5 (20%) comprised fractionated AEGs with in low WS, OI, determinism, laminarity, and RR, and in high SampEn. Classes 2 (12%), 3 (13%) and 4 (30%) suggested different degrees of AEG organization.
Conclusions: Our results expand and reinterpret the criteria used for automated AEG classification. The nine markers highlighted electrophysiological differences among the five classes found by the k-means, which could provide a more complete characterization of persAF substrate during ablation target identification in future clinical studies.
History
Alternative title
IEEE Transactions on Biomedical Engineering, 2020, https://doi.org/10.1109/TBME.2020.3021480Author affiliation
Department of Cardiovascular SciencesVersion
- AM (Accepted Manuscript)
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IEEE Transactions on Biomedical EngineeringPagination
1 - 1Publisher
Institute of Electrical and Electronics Engineers (IEEE)issn
0018-9294eissn
1558-2531Copyright date
2020Available date
2020-09-03Publisher DOI
Language
enPublisher version
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