Clinical Predictors of Termination and Clinical Outcome of Catheter Ablation for Persistent Atrial Fibrillation
Seiichiro Matsuo, MD*,*,
Nicolas Lellouche, MD*,
Matthew Wright, MBBS, PhD*,
Michela Bevilacqua, MD*,
Sébastien Knecht, MD*,
Isabelle Nault, MD*,
Kang-Teng Lim, MD*,
Leonardo Arantes, MD*,
Mark D. O'Neill, MB, BCh, DPhil*,
Pyotr G. Platonov, MD, PhD ,
Jonas Carlson, MSC, PhD,
Frederic Sacher, MD*,
Mélèze Hocini, MD*,
Pierre Jaïs, MD* and
Michel Haïssaguerre, MD*
* Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Bordeaux, France
Department of Cardiology, Lund University Hospital, Lund, Sweden
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Figure 1 Measurements of AFCL
Simultaneous measurements of the atrial fibrillatory (AF) cycle length (CL) from surface electrocardiogram (ECG) and the left and right atrial appendages (LAA and RAA). The AFCL from surface ECG, the LAA, and the RAA in this case were 139, 144, and 145 ms, respectively.
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Figure 2 AFCL Correlation
Relationship between (A) mean surface ECG AFCL measurement from 10 and 30 CL, (B) surface ECG AFCL from 10 CL and AFCL using time frequency analysis (TFA), (C) surface ECG AFCL from 10 CL and the LAA CL, and (D) surface ECG AFCL from 10 CL and the RAA CL. Abbreviations as in Figure 1.
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Figure 3 Invasive and Noninvasive Measurement of AFCL
Bland-Altman plots showing the systematic difference between the RAA CL and (A) AFCL using time frequency analysis (TFA), (B) surface ECG AFCL from 30 CL, and (C) surface ECG AFCL from 10 CL. Abbreviations as in Figure 1.
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Figure 4 Termination of Persistent AF and AFCL/Duration of AF
The receiver-operator characteristic (ROC) curve analysis of the AFCL from surface ECG (solid red line) and duration of persistent AF (dotted blue line) according to termination of persistent AF by catheter ablation. Arrows indicate optimal cutoff point for sensitivity and specificity. CI = confidence interval; other abbreviations as in Figure 1.
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Figure 5 Freedom From Arrhythmia Recurrence After Persistent AF Ablation
(A) Kaplan-Meier curve analysis of the incidence of recurrent arrhythmia after the last procedure in patients with or without the AFCL from surface ECG >142 ms. (B) Kaplan-Meier curve analysis of the incidence of recurrent arrhythmia after the last procedure in patients with or without the duration of persistent AF >21 months. CI = confidence interval; other abbreviations as in Figure 1.
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