Hidden Markov Models for Activity Detection in Atrial Fibrillation Electrograms

Rios-Muaoz, Gonzalo R; Moreno-Pino, Fernando; Soto, Nina; Olmos, Pablo M.; Artés‐Rodríguez, Antonio; Ferandez-Aviles, Francisco; Arenal, Ángel

doi:10.22489/cinc.2020.098

Cited by 1 publication

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“…The continuous electrical activity that is a footprint of RAc ( 22 ) was quantified in each CartoFinder acquisition. The electrical burden of the bipolar EGMs was measured using an automatic activity detection algorithm based on the fully unsupervised Hidden Markov Models (HMMs) ( 23 ). The method automatically detects periods of electrical activity in AF bipolar EGMs and provides a score between 0 (no activity) and 1 (continuous activity), as shown in the Supplementary Material .…”

Section: Methodsmentioning

confidence: 99%

Structural Remodeling and Rotational Activity in Persistent/Long-Lasting Atrial Fibrillation: Gender-Effect Differences and Impact on Post-ablation Outcome

Ríos-Muñoz

Soto

Ávila

et al. 2022

Front. Cardiovasc. Med.

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BackgroundStructural and post-ablation gender differences are reported in atrial fibrillation (AF). We analyzed the gender differences in structural remodeling and AF mechanisms in patients with persistent/long-lasting AF who underwent wide area circumferential pulmonary vein isolation (WACPVI).Materials and MethodsUltra-high-density mapping was used to study atrial remodeling and AF drivers in 85 consecutive patients. Focal and rotational activity (RAc) were identified with the CartoFinder system and activation sequence analysis. The impact of RAc location on post-ablation outcomes was analyzed.ResultsThis study included 64 men and 21 women. RAc was detected in 73.4% of men and 38.1% of women (p = 0.003). RAc patients had higher left atrium (LA) voltage (0.64 ± 0.3 vs. 0.50 ± 0.2 mV; p = 0.01), RAc sites had higher voltage than non-RAc sites 0.77 ± 0.46 vs. 0.53 ± 0.37 mV (p < 0.001). Women had lower LA voltage than men (0.42 vs. 0.64 mV; p < 0.001), including pulmonary vein (PV) antra (0.16 vs. 0.30 mV; p < 0.001) and posterior wall (0.34 vs. 0.51 mV; p < 0.001). RAc in the posterior atrium was recorded in few women (23.8 vs. 54.7% in men; p = 0.014). AF recurrence rate was higher in patients with RAc outside WACPVI than those with all RAc inside WACPVI or no RAc (63.4 vs. 11.1 and 31.0%; p = 0.008 and p = 0.01). Comparison of selected patients using propensity score matching confirmed lower atrial voltage (0.4 ± 0.2 vs. 0.7 ± 0.3 mV; p = 0.007) and less RAc (38 vs. 75%; p = 0.02) in women.ConclusionWomen have shown more advanced structural remodeling at ablation, which is associated with a lower incidence of RAc (usually located outside the WACPVI). These findings could explain post-ablation gender differences.

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Section: Methodsmentioning

confidence: 99%