Empirical mode decomposition of multiple ECG leads for catheter ablation long-term outcome prediction in persistent atrial fibrillation

Predictive models arouse increasing interest in clinical practice, not only to improve successful intervention rates but also to extract information of diverse physiological disorders. This is the case of persistent atrial fibrillation (AF), the most common cardiac arrhythmia in adults. Currently, catheter ablation (CA) is one of the preferred therapies to face this disease. However, selecting the best responders to CA by standard noninvasive techniques such as the electrocardiogram (ECG) remains a challenge. This work presents different predictive models for determining long-term CA outcome based on the dominant frequency (DF) of atrial activity measured in the ECG. The ensemble empirical mode decomposition (EEMD) is employed to obtain the intrinsic mode functions (IMFs) composing the ECG signal in each lead. The IMF DFs computed in multiple leads are then combined into a logistic regression (LR) model. The IMF DF features are discriminant enough to reach 79% accuracy for long-term CA outcome prediction, outperforming other methods based on DF computation. Our study shows EEMD as a valuable alternative to extract clinically relevant spectral information from AF ECGs and confirms the advantage of LR to build multivariate predictive models as compared with univariate analysis.