Atrial fibrillation (AF) initially starts in a paroxysmal form, which is mainly based on the presence of triggers. Progression of AF is accompanied by structural and electrical remodelling which can typically be described as a progressive change in electrophysiological properties of the myocardium caused by cardiovascular comorbidities and AF itself. This results in complex electrical conduction disorders, which is defined as electropathology. The aim of our study is to evaluate whether an artificial intelligence (AI)-enabled ECG algorithm (on an ECG in Sinus Rhythm) can predict electropathology in patients with AF who undergo a first PVI.
Study Type
OBSERVATIONAL
Enrollment
60
A 12-lead ECG, performed within 24 hours before the Pulmonary Vein Isolation (PVI) procedure, will be used to calculate the DNN score. (DNN score details: https://doi.org/10.1016/j.jacep.2023.04.008)
An atrial voltage map will be constructed prior to the PVI procedure.
Ziekenhuis Oost-Limburg
Genk, Limburg, Belgium
RECRUITINGLow voltage area
Proportion of low voltage area in the left atrium. (Defined as a threshold 0.5mV)
Time frame: During atrial voltage mapping, prior to PVI procedure.
Transition zone voltage area
Proportion of transition zone voltage area in the left atrium. (Defined as a threshold 1mV)
Time frame: During atrial voltage mapping, prior to PVI procedure.
Conduction delay
Number of deceleration zones in the left atrium. (Deceleration zone defined as a zone with a conduction speed of \<27cm/s)
Time frame: During atrial voltage mapping, prior to PVI procedure.
Conduction delay score
Weighted score for conduction deceleration zones (taking in account the number of affected zones and the severity of conduction delay)
Time frame: During atrial voltage mapping, prior to PVI procedure.
Conduction time from sinus node to Bachman bundle
Based on Local Activation Time (LAT) sampling. Defined as first point in right atrium to first point in left atrium.
Time frame: During atrial voltage mapping, prior to PVI procedure.
Total LA conduction time
Based on LAT sampling
Time frame: During atrial voltage mapping, prior to PVI procedure.
Left atrial appendage ejection velocity.
Measured with TEE pulsed wave doppler.
Time frame: Immediately prior to PVI procedure.
Left atrial size
Measured on CT or MRI imaging
Time frame: Prior to PVI procedure.
Pericardial adipose tissue volume
Measured on CT or MRI imaging
Time frame: Prior to PVI procedure.
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