Analysis of electrogram complexity during atrial fibrillation for ablation duration assessment

The aim of this study was to assess the reliability of the complexity analysis of single electrogram as an estimator of the length of the ablation procedure necessary for AF termination. Left and right atrial endocardial bipolar electrograms were recorded during ablation procedure of AF in 27 patients. Up to 30 second electrogram samples were measured at baseline, after each stage of ablation (LP V, roof, CFAE etc.) and prior to termination. For each electrogram, algorithmic complexity was calculated. Electrograms had significantly lower algorithmic complexity for patients who had two or less ablation stages performed than for patients for whom more than two ablation stage was performed (p < 0.001). ROC analysis showed 100% statistical sensitivity for 81% statistical specificity. These results show that algorithmic complexity increases with a number of ablation stages needed to terminate AF, which is related with the duration of the ablation procedure.Katarzyna Kośna, Piotr Podziemski, Lauren Wilson, Simon Stocman, Prashanthan Sanders, Jan Gieraltowski, Jan J Zebrowski, Pawel Kukli