Evidence map›Paper›PMID 36031620›Full record

ArticleBMC medical informatics and decision making2022

Evaluation and optimization of novel extraction algorithms for the automatic detection of atrial activations recorded within the pulmonary veins during atrial fibrillation.

Yann Prudat, Adrian Luca, Sasan Yazdani, Nicolas Derval, Pierre Jaïs, Laurent Roten, Benjamin Berte, Etienne Pruvot, Jean-Marc Vesin, Patrizio Pascale

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Article in BMC medical informatics and decision making, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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10 authors.

Yann PrudatApplied Signal Processing Group, Swiss Federal Institute of Technology, Lausanne, Switzerland.
Adrian LucaDepartment of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Sasan YazdaniApplied Signal Processing Group, Swiss Federal Institute of Technology, Lausanne, Switzerland.
Nicolas DervalHôpital Cardiologique du Haut-Lévêque and Université de Bordeaux, IHU LYRIC ANR-10-IAHU-04, Bordeaux-Pessac, France.
Pierre JaïsHôpital Cardiologique du Haut-Lévêque and Université de Bordeaux, IHU LYRIC ANR-10-IAHU-04, Bordeaux-Pessac, France.
Laurent RotenDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Benjamin BerteHeart Center, Luzerner Kantonsspital, Lucerne, Switzerland.
Etienne PruvotDepartment of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Jean-Marc VesinApplied Signal Processing Group, Swiss Federal Institute of Technology, Lausanne, Switzerland.
Patrizio PascaleDepartment of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. patrizio.pascale@chuv.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveThe automated detection of atrial activations (AAs) recorded from intracardiac electrograms (IEGMs) during atrial fibrillation (AF) is challenging considering their various amplitudes, morphologies and cycle length. Activation time estimation is further complicated by the constant changes in the IEGM active zones in complex and/or fractionated signals. We propose a new method which provides reliable automatic extraction of intracardiac AAs recorded within the pulmonary veins during AF and an accurate estimation of their local activation times.

methodsFirst, two recently developed algorithms were evaluated and optimized on 118 recordings of pulmonary vein IEGM taken from 35 patients undergoing ablation of persistent AF. The adaptive mathematical morphology algorithm (AMM) uses an adaptive structuring element to extract AAs based on their morphological features. The relative-energy algorithm (Rel-En) uses short- and long-term energies to enhance and detect the AAs in the IEGM signals. Second, following the AA extraction, the signal amplitude was weighted using statistics of the AA sequences in order to reduce over- and undersensing of the algorithms. The detection capacity of our algorithms was compared with manually annotated activations and with two previously developed algorithms based on the Teager-Kaiser energy operator and the AF cycle length iteration, respectively. Finally, a method based on the barycenter was developed to reduce artificial variations in the activation annotations of complex IEGM signals.

resultsThe best detection was achieved using Rel-En, yielding a false negative rate of 0.76% and a false positive rate of only 0.12% (total error rate 0.88%) against expert annotation. The post-processing further reduced the total error rate of the Rel-En algorithm by 70% (yielding to a final total error rate of 0.28%).

conclusionThe proposed method shows reliable detection and robust temporal annotation of AAs recorded within pulmonary veins in AF. The method has low computational cost and high robustness for automatic detection of AAs, which makes it a suitable approach for online use in a procedural context.

Indexed as

Atrial FibrillationPulmonary VeinsAlgorithmsElectrophysiologic Techniques, CardiacHumansActivation detectionAtrial fibrillationBiomedical signal processingIntracardiac electrogramsNon-linear signal processing

Identifiers

PMID36031620
PMCPMC9420290

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