Document Detail

High-density activation mapping of fractionated electrograms in the atria of patients with paroxysmal atrial fibrillation.
MedLine Citation:
PMID:  16399048     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Areas of complex fractionated atrial electrograms (CFAEs) have been implicated in the atrial substrate of atrial fibrillation (AF). The mechanisms underlying CFAE in humans are not well investigated. OBJECTIVES: The purpose of this study was to investigate the regional activation pattern associated with CFAE using a high-density contact mapping catheter. METHODS: Twenty patients with paroxysmal AF were mapped using a high-density multielectrode catheter. CFAE were mapped at 10 different sites (left atrium [LA]: inferior, posterior, roof, septum, anterior, lateral; right atrium [RA]: anterior, lateral, posterior, septum). Local atrial fibrillation cycle length (AFCL) was measured immediately before and after the occurrence of CFAE, and the longest electrogram duration (CFAEmax) was assessed. RESULTS: Longer electrogram durations were recorded in the LA compared with the RA (CFAEmax 118 +/- 21 ms vs 104 +/- 23 ms, P = .001). AFCL significantly shortened before the occurrence of CFAEmax compared with baseline (LA: 174 +/- 32 ms vs 186 +/- 32 ms, P = .0001; RA: 177 +/- 31 ms vs 188 +/- 31 ms, P = .0001) and returned to baseline afterwards. AFCL shortened by >or=10 ms in 91% of mapped sites. Two different local activation patterns were associated with occurrence of CFAEmax: a nearly simultaneous activation in all spines in 84% indicating passive activation, and a nonsimultaneous activation sequence suggesting local complex activation or reentry. CONCLUSION: Fractionated atrial electrograms during AF demonstrate dynamic changes that are dependent on regional AFCL. Shortening of AFCL precedes the development of CFAE; thus, cycle length is a major determinant of fractionation during AF. High-density mapping in AF may help to differentiate passive activation of CFAE from CFAE associated with an active component of the AF process.
Thomas Rostock; Martin Rotter; Prashanthan Sanders; Yoshihide Takahashi; Pierre Jaïs; Mélèze Hocini; Li-Fern Hsu; Fréderic Sacher; Jacques Clémenty; Michel Haïssaguerre
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  3     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-09     Completed Date:  2006-03-16     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  27-34     Citation Subset:  IM    
Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France; Université Victor Segalen Bordeaux II, Bordeaux, France.
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MeSH Terms
Atrial Fibrillation / physiopathology*
Electrophysiologic Techniques, Cardiac*
Heart Atria / physiopathology*
Middle Aged
Comment In:
Heart Rhythm. 2006 Jan;3(1):35-6   [PMID:  16399049 ]

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