Noninvasive estimation of organization in atrial fibrillation as a predictor of sinus rhythm maintenance

Previous studies indicate that the predictive value of atrial fibrillatory rate in patients undergoing cardioversion of atrial fibrillation (AF) of long duration is limited. The present study investigates signal entropy in this setting. Standard 12-lead electrocardiograms (ECGs) were recorded from 66 consecutive patients with AF undergoing cardioversion and sample entropy estimated. Patients were followed for 4 weeks. At follow-up, 59% of the patients had relapsed to AF. The AF signal entropy of these patients before cardioversion was 0.099 ± 0.015, whereas it was 0.093 ± 0.012 among the 41% maintaining sinus rhythm (P = .02). As hypothesized, signal entropy was lower in patients who maintained sinus rhythm 4 weeks after cardioversion than in those who did not. However, the overlap was large, making its clinical value limited.