Localizing Atrial Flutter Circuit using Variability in the Vectorcardiographic Loop Parameters

摘要

Atrial flutter circuit localization is usually determined during a catheter ablation procedure. Knowledge of this information beforehand could aid clinicians assess and plan the operation in advance to improve efficacy. Variability as a marker to discriminate localization non-invasively was suggested in the literature, and evaluated by one group. However, variability may originate from respiratory motion which may affect right and left AFL differently. This is hypothesized to be the reason for difference in right and left AFL variability. To address this, we analyzed the effect of removing respiratory motion influence from f wave observations on classification accuracy. ECG records from patients with AFL were processed using a novel approach: respiratory motion was estimated and removed in order to recover variability intrinsic to AFL. Vectorcardiographic loop parameters were estimated from each observation and statistical measures of the set of parameter values were calculated before being fed into a classification algorithm. The results show that f waves are negligibly affected by respiratory motion. It is also possible to discriminate circuit localization with good accuracy.