Arrhythmias & electrophysiology
Quantifying a spectrum of clinical response in atrial tachyarrhythmias using spatiotemporal synchronization of electrograms
Authors' conclusion
The area of synchronized EGMs within the atrium reveals a spectrum of clinical response in atrial tachyarrhythmias.
Study context
- Population
- Patients with atrial tachyarrhythmias (atrial tachycardia (AT) or atrial fibrillation (AF)) undergoing ablation; 35% women, 65.0 ± 10.4 years
- Participants
- 160 patients
- Comparison
- AT vs AF with termination by ablation vs AF without termination
- AF terminationn = 75
- Non-terminationn = 75reference
- ATn = 10
- Outcome
- Size of synchronized EGM regions (REACT)
Methodological detailspropensity matched, 64-pole basket mapping, simulations, unsupervised machine learning
- Propensity matched
- 64-pole basket mapping
- Simulations
- Unsupervised machine learning
Main finding
As reported in the abstract
AT
0.63
± 0.15
AF termination
0.37
± 0.22
AF non-termination
0.22
± 0.18
P < 0.001
- AUC for predicting AF termination in hold-out cohorts
- 0.72 ± 0.03
Further findings
Prediction of AF termination in hold-out cohorts
- AUC
- 0.72 ± 0.03
Unsupervised machine learning of repetitive activity (REACT) and 50 clinical variables
- 4 clusters of increasing risk for AF termination
- P < 0.01
- More predictive than clinical profiles alone
- P < 0.001
- χ2
Simulations
- Lower REACT represented greater variability in clinical electrogram (EGM) timing and shape
Original publication
Quantifying a spectrum of clinical response in atrial tachyarrhythmias using spatiotemporal synchronization of electrograms. Europace. Published 18 March 2023. doi:10.
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