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On a Possible Approach to Risk Prediction of Recurrence of Atrial Fibrillation аfter Catheter Ablation According to Data from the Pre-procedure Period

Iskren Garvanski, Mikhail Matveev, , Todor Stoyanov, Iana Simova

Abstract: The aim of the study is to identify and evaluate predictors of recurrent paroxysms of atrial fibrillation (AF) paroxysms based on data from the preprocedural period among personal indices, history, comorbidities, ultrasound examination, and morphological components of f-waves, such as spectral amplitude and frequency. 39 patients with antral pulmonary vein isolation using radiofrequency or cryoenergy were included. Spectral analysis of f-waves was performed by fast Fourier transform of the ECG signal after suppression of the T-wave and QRS-complex. The performed U-test for the difference between the amplitude and frequency indicators in the groups without and with recurrence of AF shows a significant difference between the amplitude values in the two studied groups of patients. Through a stepwise discriminant analysis of a total of 14 indicators, 5 reliably separated groups without and with recurrence were determined: Echo LV-EF, spectral amplitude of f-waves, heart failure, Stroke/TIA, diabetes. The discriminator synthesized on these indicеs classified among the 39 patient – 25 without relapse (group 1) and 14 with relapse (group 2), 3 patients wrong from group 1 to group 2 (false positive), or 12%, and 1 patient was wrong from group 2 to group 1 (false negative), or 7.1%. These results give grounds to accept the hypothesis that it is possible to develop a decision rule for determining the degree of risk of post-procedural recurrence of AF from pre-procedural period data.

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