| Effect of pulmonary vein isolation on the distribution of complex fractionated electrograms in humans. | |
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MedLine Citation:
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PMID: 19187903 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Targeting of complex fractionated electrograms (CFEs) has been used as an adjunctive strategy to pulmonary vein isolation (PVI) in patients with persistent atrial fibrillation (AF). However, it is unclear whether CFEs should be targeted before or after PVI. OBJECTIVES: The purpose of this study was to examine the effect of PVI on CFE distribution in humans. METHODS: We compared left atrial (LA) CFE maps acquired using the NavX system before and after PVI in patients with persistent AF. CFE maps were constructed from bipolar electrograms acquired from a circular mapping catheter. At each point, the mean AF cycle length (CL) was calculated automatically by averaging the intervals between deflections over a 4-second window. Sites with mean CL < or =120 ms were considered CFE+. RESULTS: A total of 22 consecutive patients (82% male, age 58 +/- 9 years) were studied. At baseline, 47% of the LA was encompassed by electrograms with CL <120 ms. PVI had a significant effect on CFE characteristics, with an increase in mean LA AF CL (144 ms pre-PVI vs. 214 ms post-PVI; P <.01) and a decrease in CFE+ LA surface area (47% vs 23%; P <.01). There was significant reduction in CFE burden after PVI in both PV (50% vs. 6%; P <.01) and non-PV (61% vs. 39%; P <.01) regions. CONCLUSIONS: In patients with persistent AF, PVI results in a significant decrease in both PV and non-PV areas of CFE. To limit extensive LA ablation, PVI should be performed before targeting CFE when a combined approach is pursued. |
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Authors:
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Jean-François Roux; Sattar Gojraty; Rupa Bala; Christopher F Liu; Sanjay Dixit; Mathew D Hutchinson; Fermin Garcia; David Lin; David J Callans; Michael Riley; Francis Marchlinski; Edward P Gerstenfeld |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-11-06 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 6 ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-02-03 Completed Date: 2009-07-07 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 156-60 Citation Subset: IM |
Affiliation:
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Section of Cardiovascular Electrophysiology, Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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physiopathology*,
surgery* Catheter Ablation* Chi-Square Distribution Electrocardiography / methods* Female Humans Male Middle Aged Pulmonary Veins / physiopathology*, surgery* Statistics, Nonparametric Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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