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Catheter ablation has become an important treatment for atrial fibrillation (AF), but its recurrence rate is still high. The aim of this study was to predict AF recurrence using a three-dimensional (3D) network model based on body-surface potential mapping signals (BSPMs). BSPMs were recorded with a 128-lead vest in 14 persistent AF patients before undergoing catheter ablation (Maze-IV). The torso geometry was acquired and meshed by point cloud technology, and the BSPM was interpolated into the torso geometry by the inverse distance weighted (IDW) method to generate the isopotential map. Experiments show that the isopotential map of BSPMs can reflect the propagation of the electrical wavefronts. The 3D isopotential sequence map was established by combining the spatial–temporal information of the isopotential map; a 3D convolutional neural network (3D-CNN) model with temporal attention was established to predict AF recurrence. Our study proposes a novel attention block that focuses the characteristics of atrial activations to improve sampling accuracy. In our experiment, accuracy (ACC) in the intra-patient evaluation for predicting the recurrence of AF was 99.38%. In the inter-patient evaluation, ACC of 3D-CNN was 81.48%, and the area under the curve (AUC) was 0.88. It can be concluded that the dynamic rendering of multiple isopotential maps can not only comprehensively display the conduction of cardiac electrical activity on the body surface but also successfully predict the recurrence of AF after CA by using 3D isopotential sequence maps.

Although radio frequency ablation is the most effective treatment for atrial fibrillation (AF), there is still a high recurrence rate. The purpose of this paper was to initially assess the probability of the recurrence of AF based on the preoperative body surface potential mapping (BSPM) signals, in other words, to predict the efficiency of ablation and assist physicians in developing more effective treatment options. At present, deep learning methods based on convolutional neural networks (CNNs) do not require complex mathematical abstractions or manual interventions; thus, higher computation efficiency can be obtained in such research. However, the use of the fully connected multi-layer perceptron (MLP) algorithms has shown low classification performance. This paper proposes an improved CNN algorithm (CNN-SVM method) for the recurrence classification in AF patients by combining with the support vector machine (SVM) architecture. The algorithm is validated on the preoperative AF signals of 14 patients for classification. All postoperative patients are followed up for one year; ten of them remain in sinus rhythm, whereas the other four turn back to AF. The ECG data for these patients are obtained through the 128-Lead BSPM system. The results show that the proposed CNN-SVM method can automatically extract the characteristic information through the CNN network. The constructed model ultimately achieved an accuracy of 96%, a sensitivity of 88%, and a specificity of 96%. It is concluded that the CNN-SVM method solves the drawbacks of MLP only for separating linear data. It improves the overall performance of AF recurrence classification, thereby providing a valuable reference for doctors to develop personalized treatment plans.

Atrial fibrillation (AF) is a common clinical arrhythmia with a lifetime risk and has become an attractive topic of clinical research and health management. Although the 12-lead classical ECG configuration is adequate for the detection of AF, its configuration is suboptimal for constructing surface potential mapping or extracting other diagnostic features during AF. Body surface potential mapping (BSPM) has a broad application prospect in AF study, but the electrode wiring is complicated and the hardware cost is high. This paper proposes a method to improve the performance of leads selection algorithm from a 128-lead BSPM system with equidistantly spaced electrodes. 128-lead BSPM data obtained from 8 AF patients were used in the study. Leads selection was performed by a sequential selection based on an adapted Botteron's approach and multiple linear regression. The result showed that the proposed method has significant improvement on the performance of the accurate reconstruction of dominant frequency on the patient-specific dataset. The proposed method may not only improve the performance on the spectrum characteristic but also effectively improve the performance of time domain criteria when the number of selected leads is above 12.