Comput Methods Programs Biomed - Optimization of novel spectral estimator for fractionated electrogram analysis is helpful to discern atrial fibrillation type.

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Resumo

TRODUCTION: Paroxysmal versus persistent atrial fibrillation (AF) can be distinguished based on differences in the spectral parameters of fractionated atrial electrograms. Maximization of these differences would improve characterization of the arrhythmogenic substrate. A novel spectral estimator (NSE) has been shown previously to provide greater distinction in AF spectral parameters as compared with the Fourier transform estimator. Herein, it is described how the differences in NSE spectral parameters can be further improved.METHOD: In 10 persistent and 9 paroxysmal AF patients undergoing electrophysiologic study, fractionated electrograms were acquired from the distal bipolar ablation electrode. A total of 204 electrograms were recorded from the pulmonary vein (PV) antra and from the anterior and posterior left atrial free wall. The following spectral parameters were measured: the dominant frequency (DF), which reflects local activation rate, the DF amplitude (DA), and the mean spectral profile (MP), which represents background electrical activity. To optimize differences in parameters between paroxysmal versus persistent AF patients, the NSE was varied by selectively removing subharmonics, using a threshold. The threshold was altered in steps to determine the optimal subharmonics removal.RESULTS: At the optimal threshold level, mean differences in persistent versus paroxysmal AF spectral parameters were: DA=+0.371 mV, DF=+0.737 Hz, and MP=-0.096 mV. When subharmonics were not removed, the differences were substantially less: DA=+0.301 mV, DF=+0.699 Hz, and MP=-0.063 mV.CONCLUSIONS: NSE optimization produces greater spectral parameter difference between persistent versus paroxysmal AF data. Quantifying spectral parameter differences can be assistive in characterizing the arrhythmogenic substrate.

Resumo Limpo

troduct paroxysm versus persist atrial fibril af can distinguish base differ spectral paramet fraction atrial electrogram maxim differ improv character arrhythmogen substrat novel spectral estim nse shown previous provid greater distinct af spectral paramet compar fourier transform estim herein describ differ nse spectral paramet can improvedmethod persist paroxysm af patient undergo electrophysiolog studi fraction electrogram acquir distal bipolar ablat electrod total electrogram record pulmonari vein pv antra anterior posterior left atrial free wall follow spectral paramet measur domin frequenc df reflect local activ rate df amplitud da mean spectral profil mp repres background electr activ optim differ paramet paroxysm versus persist af patient nse vari select remov subharmon use threshold threshold alter step determin optim subharmon removalresult optim threshold level mean differ persist versus paroxysm af spectral paramet da mv df hz mp mv subharmon remov differ substanti less da mv df hz mp mvconclus nse optim produc greater spectral paramet differ persist versus paroxysm af data quantifi spectral paramet differ can assist character arrhythmogen substrat

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