Abstract 13204: Re-Induction of Atrial Fibrillation Changes Electrogram and ECG Characteristics in Ablation Patients: Insights Using Novel Signal Analyses
Introduction: We analyzed electrograms (EGM) in atrial fibrillation (AF) patients at three time points during catheter ablation procedures in order to assess the changes that occur in AF signal characteristics: Time A ) AF at baseline; Time B ) AF after pulmonary vein isolation (PVI) and; Time C ) AF after post-PVI cardioversion and subsequent re-induction for at least 5 minutes.
Methods: We used novel signal analysis techniques to characterize EGMs in 39 persistent AF patients. The following previously-defined parameter were collected and analyzed from posterior left atrial EGMs: 1) dominant frequency , 2) AF frequency spectral complexity , 3) variations in EGM morphology , and 4) repetitiveness of EGM patterns.
Results: When compared to baseline AF, there were significant differences in re-induced AF, but not post-PVI AF, for: 1) EGM dominant frequency (p=0.22 for baseline vs. post-PVI, p<0.01 for baseline vs. re-induced, and p=0.02 for post-PVI vs. re-induced) and 2) EGM-based spectral complexity (p=0.85 for baseline vs. post-PVI, p=0.02 for baseline vs. re-induced, and p=0.05 for post-PVI vs. re-induced). Neither post-PVI AF nor re-induced AF resulted in significant differences for: 3) EGM morphology variation and 4) EGM pattern repetitiveness.
Conclusions: Novel AF signal analysis techniques reveal that left atrial frequency and EGM signal characteristics remain stable through the course of a PVI procedure. However, AF re-induction leads to changes in both AF activation rates and spectral complexity, while not affecting EGM characteristics of morphology and pattern repetitiveness. Further studies of how AF re-induction changes these EGM properties, and the clinical interpretation of AF re-induction during ablation procedures, are wararanted.
- © 2013 by American Heart Association, Inc.