PO-02-169 PATTERNS OF PULMONARY VEIN ACTIVITY RECORDED DURING PERSISTENT AF MAY HELP IDENTIFY THEIR CONTRIBUTION TO THE MECHANISM OF AF

Pulmonary vein isolation (PVI) is the cornerstone interventional treatment for AF but success of this approach more limited in persistent (PsAF). In these pts, main challenge to discriminate those who will respond PVI only, from may require an extended ablation strategy. We sought characterize patterns electrical activity recorded within PVs based on their postulated contribution mechanism PsAF. Three subgroups consecutive pts underwent PsAF were considered AF: 1) definitely PV-related: procedural termination during (“PVI-term” group) 2) likely absence recurrence > 18 months off-AAD after only (“PVI-success” 3) definitely/likely PV-unrelated: despite isolated PV or at least one redo, respectively (“PVI-failure” group). Each and left atrial appendage evaluated before ablation. An automatic detection algorithm was developed extract activations intra-cardiac electrograms order perform further analyses. Epochs 60-sec used. Different methods cycle length (CL) variability assessed best potential markers such as occurrence bursts rapid activity. A total 40 included (mean age: 60 ± 10 years, mean duration: 11 months): PVI-term group (n=10), PVI-success (n=17), PVI-failure (n= 13). The dynamics activation intervals using envelope time series. Among all features evaluated, feature that could similarly both group, standard deviation inferior relative median CL (p <0.001 p = 0.005, respectively) (Fig. A-B). Cut-off selected by ROC analysis provided a 100% sensitivity 85% specificity PV-failure (AUC 0.931) 88% 77% 0.805). This performed better than recently reported “Fastest run” fastest 10-beat run) 0.762 AUC 0.738, C). Patterns differ according Their evaluation provide key be cured only.