Atrial Fibrillation
Conditions
Keywords
Artificial Intelligence, Deep Neural Network, Electrocardiogram, Pulmonary Vein Isolation
Brief summary
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.
Interventions
DIAGNOSTIC_TESTAtrial voltage map in sinus rhythm
An atrial voltage map will be constructed prior to the PVI procedure.
DIAGNOSTIC_TESTAI-enabled ECG score for Atrial Fibrillation (DNN score)
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)
Sponsors
Ziekenhuis Oost-Limburg
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Provide signed and dated informed consent. * First PVI-procedure * Age is 18 years or higher. * 12-lead ECG available in SR during the last 14 days.
Exclusion criteria
* Mitral insufficiency of grade 3 or 4. * Participating in another study that may interfere with participation in this study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Low voltage area | During atrial voltage mapping, prior to PVI procedure. | Proportion of low voltage area in the left atrium. (Defined as a threshold 0.5mV) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Transition zone voltage area | During atrial voltage mapping, prior to PVI procedure. | Proportion of transition zone voltage area in the left atrium. (Defined as a threshold 1mV) |
| Conduction delay | During atrial voltage mapping, prior to PVI procedure. | Number of deceleration zones in the left atrium. (Deceleration zone defined as a zone with a conduction speed of \<27cm/s) |
| Conduction delay score | During atrial voltage mapping, prior to PVI procedure. | Weighted score for conduction deceleration zones (taking in account the number of affected zones and the severity of conduction delay) |
| Pericardial adipose tissue volume | Prior to PVI procedure. | Measured on CT or MRI imaging |
| Total LA conduction time | During atrial voltage mapping, prior to PVI procedure. | Based on LAT sampling |
| Left atrial appendage ejection velocity. | Immediately prior to PVI procedure. | Measured with TEE pulsed wave doppler. |
| Left atrial size | Prior to PVI procedure. | Measured on CT or MRI imaging |
| Conduction time from sinus node to Bachman bundle | During atrial voltage mapping, prior to PVI procedure. | Based on Local Activation Time (LAT) sampling. Defined as first point in right atrium to first point in left atrium. |
Countries
Belgium
Contacts
Primary ContactHenri M.P.B.C. Gruwez, MD
Outcome results
None listed