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Title: Unsupervised k‐mean classification of atrial electrograms from human persistent atrial fibrillation
Authors: Almeida, TP
Soriano, DC
Li, X
Chu, GS
Salinet, JL
Schlindwein, FS
Stafford, PJ
Ng, GA
Yoneyama, T
First Published: 23-Sep-2018
Presented at: Computing in Cardiology 2018
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Citation: Computing in Cardiology 2018; Vol 45
Abstract: The dichotomous criterion for atrial electrogram (AEG) classification as proposed by commercial systems (normal/fractionated) to guide ablation has been shown insufficient for persistent atrial fibrillation (persAF) therapy. In this study, we used unsupervised classification to investigate possible sub-groups of persAF AEGs. 3745 bipolar AEGs were collected from 14 persAF patients after pulmonary vein isolation. Automated AEG classification (normal/fractionated) was performed using the CARTO criterion (Biosense Webster). The CARTO attributes (ICL, ACI and SCI) were used to create a 3D space distribution. K-mean with five groups was implemented. Group 1 (43%) represents normal AEGs with low ICL, high ACI and SCI. Groups 2 (9%) and 3 (9%) have shown similar low ICL, but Group 3 has shown AEGs with short activation intervals, as opposed to Group 2. Group 4 (23%) suggests moderated fractionation, with high ACI but low SCI. Group 5 (15%) has shown highly fractionated AEGs with high ICL, low ACI and SCI. The three attributes were significantly different among the five groups (P<0.0001), except ICL between Groups 3 and 4 (P>0.999) and SCI between Groups 3 and 5 (P>0.999). The five sub-groups of AEGs found by the k-mean have shown distinct characteristics, which could provide a more detailed characterization of the atrial substrate during ablation.
DOI Link: 10.22489/CinC.2018.127
ISSN: 2325-887X
Version: Publisher Version
Status: Peer-reviewed
Type: Conference Paper
Rights: Copyright © the authors, 2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Appears in Collections:Conference Papers & Presentations, Dept. of Cardiovascular Sciences

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