Ludmila Sidorenko

Moldova

New biotechnology in biosignal analysis of cardiorhythmograms to visualize triggers for predicting atrial fibrillation onset

Ludmila Sidorenko1, Anand Muraleedharan1, Daria Zalesskaia1, Anaswara Vijayakumar1, Fauizi Mohammad1, Vitalie Cobzac2, Viorel Nacu2, Niels Wessel3,4

1. Department of Molecular Biology and Human Genetics, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
2. ?Laboratory of Tissue Engineering and Cell Cultures, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
3. Department of Cardiovascular Physics, Humboldt Universität zu Berlin, Berlin, Germany
4. Medical School Berlin GmbH, Berlin, Germany

Abstract

Background

Pulmonary vein isolation (PVI), a recent therapy for atrial fibrillation (AF), however a significant non-responder rate of around 45%. For the pre-PVI outcome prediction, medical decision-makers should thus additionally take into the account alternative pathophysiologic trigger mechanisms outside of the left atrial trigger foci. The purpose of this study was to evaluate the potential of a new visualization technique for identifying elevated suprasegmental cardioneural coupling in order to predict AF recurrence following PVI.

Methods

Eighty participants participated in a prospective trial. Four biosignal recordings were included: three throughout the 12-month pos-PVI follow-up period and one at baseline. An ECG steady-state recording lasting five minutes served as the biosignal. Additionally, using the time-domain approach, the data was converted into a cardiorhythmogram (CRG).
By analyzing two parameters, LF drops and HF counterregulation, the unique technique allows for the visualization of greater suprasegmental cardioneural coupling in compared to typical CRG analysis in terms of standard heart rate variability

Results

These new parameters demonstrated remarkably high specificity and sensitivity. This method has the advantage of guaranteeing a real-time visualization of AF trigger states, which doctors can do in terms of diagnosis at a glance, as well as a long-term prognosis, which is backed by the non-linear CRG analysis and the evaluation of the second parameter, HF counterregulation. Coordigrams for the cardio-respiratory coupling of the biosignals were created as a proof of concept.

Conclusions

The new biotechnology for cardiorhythmogram analysis is able to anticipate possible non-responders to PVI pre-interventionally and to help responders choose the best timing for PVI intervention to stay long-term free of AF recurrence, with the goal of assisting decision-makers using the new visualization technique by the predictors LF drops and HF counterregulation.