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<p>Electrical cardioversion presents one of the treatment options for atrial fibrillation (AF). However, the early recurrence rate is high, reaching ~40% three months after the procedure. Features based on vectorcardiographic signals were explored to find association with early recurrence of AF. Eighty-four patients with non-paroxysmal AF referred to electrical cardioversion were prospectively studied; early AF recurrence was present in 40 (47.6%). Patients underwent 24-h Holter ECG monitoring three months after the procedure to assess AF recurrence. Pre-procedural 12-lead ECGs (10&#xa0;s, 1&#xa0;kHz) were recorded and automatically analyzed. We explored associations of VCG-based features with early AF recurrence. Two features were strongly associated with AF recurrence: (1) a mean VCG (y-axis) signal slope in a window starting 145 ms before QRS center, lasting for 190 ms (AUC 0.778, <i>p</i> &lt; 0.001), and (2) a mean VCG (z-axis) signal slope in a window starting 60 ms after QRS center, lasting for 465 ms (AUC 0.744, <i>p</i> &lt; 0.001). These features showed higher association to the outcome than eighteen baseline clinical features. Our approach revealed features based on a slope of vectorcardiographic signals. This work also suggests that state of ventricles strongly affects the AF recurrence after electrical cardioversion.</p>

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Automatically optimized vectorcardiographic features are associated with recurrence of atrial fibrillation after electrical cardioversion

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月8日

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  • F. Plesinger,
  • S. Hassouna,
  • Z. Carna,
  • J. Vesela,
  • R. Smisek,
  • E. Vargova,
  • V. Sobota,
  • Z. Koscova,
  • P. Nejedly,
  • I. Viscor,
  • F. W. Prinzen,
  • P. Jurak,
  • J. Halamek,
  • P. Osmancik

摘要

Electrical cardioversion presents one of the treatment options for atrial fibrillation (AF). However, the early recurrence rate is high, reaching ~40% three months after the procedure. Features based on vectorcardiographic signals were explored to find association with early recurrence of AF. Eighty-four patients with non-paroxysmal AF referred to electrical cardioversion were prospectively studied; early AF recurrence was present in 40 (47.6%). Patients underwent 24-h Holter ECG monitoring three months after the procedure to assess AF recurrence. Pre-procedural 12-lead ECGs (10 s, 1 kHz) were recorded and automatically analyzed. We explored associations of VCG-based features with early AF recurrence. Two features were strongly associated with AF recurrence: (1) a mean VCG (y-axis) signal slope in a window starting 145 ms before QRS center, lasting for 190 ms (AUC 0.778, p < 0.001), and (2) a mean VCG (z-axis) signal slope in a window starting 60 ms after QRS center, lasting for 465 ms (AUC 0.744, p < 0.001). These features showed higher association to the outcome than eighteen baseline clinical features. Our approach revealed features based on a slope of vectorcardiographic signals. This work also suggests that state of ventricles strongly affects the AF recurrence after electrical cardioversion.