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  • Manifold analysis of the P-...
    Martinez-Mateu, Laura; Melgarejo-Meseguer, Francisco M.; Muñoz-Romero, Sergio; Gimeno-Blanes, Francisco-Javier; García-Alberola, Arcadi; Rocher-Ventura, Sara; Saiz, Javier; Rojo-Álvarez, José Luis

    Computers in biology and medicine, March 2023, 2023-03-00, 20230301, Letnik: 155
    Journal Article

    In atrial fibrillation (AF) ablation procedures, it is desirable to know whether a proper disconnection of the pulmonary veins (PVs) was achieved. We hypothesize that information about their isolation could be provided by analyzing changes in P-wave after ablation. Thus, we present a method to detect PV disconnection using P-wave signal analysis. Conventional P-wave feature extraction was compared to an automatic feature extraction procedure based on creating low-dimensional latent spaces for cardiac signals with the Uniform Manifold Approximation and Projection (UMAP) method. A database of patients (19 controls and 16 AF individuals who underwent a PV ablation procedure) was collected. Standard 12-lead ECG was recorded, and P-waves were segmented and averaged to extract conventional features (duration, amplitude, and area) and their manifold representations provided by UMAP on a 3-dimensional latent space. A virtual patient was used to validate these results further and study the spatial distribution of the extracted characteristics over the whole torso surface. Both methods showed differences between P-wave before and after ablation. Conventional methods were more prone to noise, P-wave delineation errors, and inter-patient variability. P-wave differences were observed in the standard leads recordings. However, higher differences appeared in the torso region over the precordial leads. Recordings near the left scapula also yielded noticeable differences. P-wave analysis based on UMAP parameters detects PV disconnection after ablation in AF patients and is more robust than heuristic parameterization. Moreover, additional leads different from the standard 12-lead ECG should be used to detect PV isolation and possible future reconnections better. •Changes in P-waves of ECG signals are observed after pulmonary veins ablation.•P-wave analysis based on UMAP method is more robust than heuristic parameterization.•A plurality of signals from standard 12-lead ECG detects pulmonary veins isolation.•Leads different from standard 12-lead ECG improve P-wave changes detection.