Entropy at the right atrium as a predictor of atrial fibrillation recurrence outcome after pulmonary vein ablation

Abstract

Atrial fibrillation (AF) recurrence rates after successful ablation procedures are still high and difficult to predict. This work studies the capability of entropy measured from intracardiac recordings as an indicator for recurrence outcome. Intra-atrial recordings from 31 AF patients were registered previously to an ablation procedure. Four electrodes were located at the right atrium (RA) and four more at the left atrium (LA). Sample entropy measurements were applied to these signals, in order to characterize different non-linear AF dynamics at the RA and LA independently. In a 3 months follow-up, 19 of them remained in sinus rhythm, whereas the other 12 turned back to AF. Entropy values can be associated to a proarrhythmic indicator as they were higher in patients with AF recurrence (1.11±0.15 vs. 0.91±0.13), in persistent patients (1.03±0.19 vs. 0.96±0.15), and at the LA with respect to the RA (1.03±0.23 vs. 0.89±0.15 for paroxysmal AF patients). Furthermore, entropy values at the RA arose as a more reliable predictor for recurrence outcome than at the LA. Results suggest that high entropy values, especially at the RA, are associated with high risk of AF recurrence. These findings show the potential of the proposed method to predict recurrences post-ablation, providing additional insights to the understanding of arrhythmia.

Multiscale Principal Component Analysis to Predict Atrial Fibrillation Reversion to Sinus Rhythm

“…Certainly, the results described showed differences in shannon entropy between both atria in recurrent and nonrecurrent AF group, but with higher atrial gradient in the patients that maintenance sinus rhythm. Previous studies have showed that patients that remained in sinus rhythm presented different entropy values tan those who turned back to AF [14].…”

“…In addition, the dominant atrial frequency has been described as a predictor of AF ablation outcome, where long cycle lengths were responsible for the organization of the arrhythmia, whereas the shortest cycle lengths were related to recurrences [12]. Based on mechanistic studies, rotor sites are expected to exhibit greater electrical periodicity, unique spectral characteristics such as higher dominant frequency [13], and higher entropy [14,15], distinguishing them from other atrial sites [16]. Dominant frequency from atrial signals extracted with MSPCA showed a differences in left atrium main frequency in the left atrium with a more rapid activity in the patients with recurrences in the arrhythmia.…”

Singular Spectrum Analysis of Atrial Activations to Predict Atrial Fibrillation Recurrence After Ablation Procedure

“…The high-DF sites produce a favourable condition for maintenance of AF [16]. Based on mechanistic studies, these areas exhibit higher dominant frequency [17], higher entropy [18] and lower causality from the pulmonary veins to the atria [19], distinguishing them from other atrial sites [20].…”

Prediction of Atrial Fibrillation Recurrence by Pulmonary Vein Electrogram Correlation

“…Moreover, high dominant atrial frequency sites are reported to be related to the center of a focal-firing rotor or local reentry circuit, producing a favourable condition for maintenance of AF [11]. Based on mechanistic studies, rotor sites are expected to exhibit greater electrical periodicity, unique spectral characteristics such as higher dominant frequency [12], and higher entropy [13] and lower causality from the PV to the atria [14].…”