Document Detail

Characteristics of complex fractionated electrograms in nonpulmonary vein ectopy initiating atrial fibrillation/atrial tachycardia.
MedLine Citation:
PMID:  19804543     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Nonpulmonary vein (PV) ectopy initiating atrial fibrillation (AF)/atrial tachycardia (AT) is not uncommon in patients with AF. The relationship of complex fractionated atrial electrograms (CFAEs) and non-PV ectopy initiating AF/AT has not been assessed. We aimed to characterize the CFAEs in the non-PV ectopy initiating AF/AT. METHODS: Twenty-three patients (age 53 +/- 11 y/o, 19 males) who underwent a stepwise AF ablation with coexisting PV and non-PV ectopy initiating AF or AT were included. CFAE mapping was applied before and after the PV isolation in both atria by using a real-time NavX electroanatomic mapping system. A CFAE was defined as a fractionation interval (FI) of less than 120 ms over 8-second duration. A continuous CFAE (mostly, an FI < 50 ms) was defined as electrogram fractionation or repetitive rapid activity lasting for more than 8 seconds. RESULTS: All patients (100%) with non-PV ectopy initiating AF or AT demonstrated corresponding continuous CFAEs at the firing foci. There was no significant difference in the FI among the PV ostial or non-PV atrial ectopy or other atrial CFAEs (54.1 +/- 5.6, 58.3 +/- 11.3, 52.8 +/- 5.8 ms, P = 0.12). Ablation targeting those continuous CFAEs terminated the AF and AT and eliminated the non-PV ectopy in all patients (100%). During a follow-up of 7 months, 22% of the patients had an AF recurrence with PV reconnections. There was no recurrence of any ablated non-PV ectopy during the follow-up. CONCLUSION: The sites of the origin of the non-PV ectopies were at the same location as those of the atrial continuous CFAEs. Those non-PV foci were able to initiate and sustain AF/AT. By limited ablation targeting all atrial continuous CFAEs, the AF could be effectively eliminated.
Li-Wei Lo; Yenn-Jiang Lin; Hsuan-Ming Tsao; Shih-Lin Chang; Yu-Feng Hu; Wen-Chin Tsai; Da-Chun Tuan; Chien-Jung Chang; Pi-Chang Lee; Ching-Tai Tai; Wei-Hua Tang; Kazuyoshi Suenari; Shih-Yu Huang; Satoshi Higa; Shih-Ann Chen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  20     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-03-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1305-12     Citation Subset:  IM    
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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MeSH Terms
Atrial Fibrillation / diagnosis*,  etiology*
Body Surface Potential Mapping / methods*
Diagnosis, Differential
Middle Aged
Pulmonary Veins
Reproducibility of Results
Sensitivity and Specificity
Tachycardia, Ectopic Atrial / diagnosis*,  etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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