scholarly journals Sustained and self‐terminating atrial fibrillation induced immediately after pulmonary vein isolation exhibit differences in coronary sinus electrical activity from onset

2019 ◽  
Vol 31 (1) ◽  
pp. 150-159 ◽  
Author(s):  
Nicolas Johner ◽  
Mehdi Namdar ◽  
Dipen C. Shah
Keyword(s):  
Atrial Fibrillation ◽  
Electrical Activity ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Coronary Sinus

scholarly journals Kolmogorov Complexity of Coronary Sinus Atrial Electrograms before Ablation Predicts Termination of Atrial Fibrillation after Pulmonary Vein Isolation

Entropy ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. 970 ◽  
Author(s):  
Stępień ◽  
Kuklik ◽  
Żebrowski ◽  
Sanders ◽  
Derejko ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Coronary Sinus ◽  
Kolmogorov Complexity ◽  
Similarity Index ◽  
Dominant Frequency ◽  
Significant Difference ◽  
The Rich

Atrial fibrillation (AF) is related to a very complex local electrical activity reflected in the rich morphology of intracardiac electrograms. The link between electrogram complexity and efficacy of the catheter ablation is unclear. We test the hypothesis that the Kolmogorov complexity of a single atrial bipolar electrogram recorded during AF within the coronary sinus (CS) at the beginning of the catheter ablation may predict AF termination directly after pulmonary vein isolation (PVI). The study population consisted of 26 patients for whom 30 s baseline electrograms were recorded. In all cases PVI was performed. If AF persisted after PVI, ablation was extended beyond PVs. Kolmogorov complexity estimated by Lempel–Ziv complexity and the block decomposition method was calculated and compared with other measures: Shannon entropy, AF cycle length, dominant frequency, regularity, organization index, electrogram fractionation, sample entropy and wave morphology similarity index. A 5 s window length was chosen as optimal in calculations. There was a significant difference in Kolmogorov complexity between patients with AF termination directly after PVI compared to patients undergoing additional ablation (p < 0.01). No such difference was seen for remaining complexity parameters. Kolmogorov complexity of CS electrograms measured at baseline before PVI can predict self-termination of AF directly after PVI.

Preferential conduction patterns along the coronary sinus during atrial fibrillation in humans and their modification by pulmonary vein isolation

2011 ◽  
Vol 44 (2) ◽  
pp. 157-163
Author(s):  
Pyotr G. Platonov ◽  
Prashanthan Sanders ◽  
Shashidhar ◽  
Anthony Brooks ◽  
Jari M. Tapanainen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Coronary Sinus

Assessing the atrial substrate: electrograms from the coronary sinus can predict left atrial fibrosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Mohsen ◽  
J Draheim ◽  
N Grossmann ◽  
C.H Turan ◽  
M Schoett ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Coronary Sinus ◽  
Left Atrial ◽  
Pearson Correlation ◽  
Atrial Fibrosis ◽  
Atrial Ablation ◽  
Left Atrial Fibrosis ◽  
Diagnostic Catheter

Abstract Background Left atrial fibrosis plays a key role regarding the success rate of pulmonary vein isolation for atrial fibrillation. It can be analyzed using LGE-MRI or invasive LA electroanatomical mapping. Assessing LA substrate prior to performing LA ablation procedures might help in optimizing the ablation approach. Method We analysed highdensity-electroanatomical maps of the left atrium derived by Carto 3 from 282 consecutive atrial fibrillation patients scheduled for RF pulmonary vein isolation (PVI). Maps were divided into 5 different anatomical areas and fibrosis was defined as local voltage &lt;0.5mV. The extent of fibrosis was analyzed and compared with signal recordings from different positions of a diagnostic catheter positioned in the coronary sinus (CS) using Pearson correlation analysis. Results PVI was carried out in 282 patients (male 72%, mean age 63±10.8 years). A minimum of 1000 evenly distributed local electrograms were recorded in every patient. Significant LA fibrosis (&gt;5%) was present in 54% of the patients with the maximum incidence of 100% at the anterior and 80% at the posterior wall. Signal amplituds in the proximal CS position significantly correlated with presence of LA fibrosis in the posterior LA (R 0.84, p&lt;0.001), LA roof (R 0.65; p&lt;0.001), left lateral (R 0.54; p&lt;0.001), septal (R 0.47; p&lt;0.001), and even LA anterior wall (R 0.56; p&lt;0.001). Comparable results were found when using distal CS signals or a signal averaged over all individual CS signals. When used as a diagnostic tool, a CS amplitude &lt;1.9mV could predict fibrosis at the posterior left atrial wall with a specificity of 97% and a sensitivity of 67% (PLR 24, AUC 0.91, 95% CI 0.87 - 0.95; p&lt;0.001). A cut-off value of 1.9mV could be used to identify patients with only minimal LA fibrosis (&lt;5%) with specificity of 88% and a sensitivity of 50% (PLR 4.2, AUC 0.81, 95% CI 0.71–0.89; p&lt;0.001. Conclusion Voltage signals in the CS are significantly associated with presence of fibrosis in all left atrial areas. Moreover, CS voltage signals can be used to identify presence of significant left atrial extrapulmonary vein fibrosis and could help guiding left atrial ablation procedures and choice of ablation technique. Funding Acknowledgement Type of funding source: None

Conduction patterns in the coronary sinus during atrial fibrillation and their modification by pulmonary vein isolation

2011 ◽  
Vol 44 (2) ◽  
pp. e11
Author(s):  
Pyotr Platonov ◽  
Prashanthan Sanders ◽  
Shashidar ◽  
Anthony Brooks ◽  
Fredrik Holmqvist ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Coronary Sinus
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