Document Detail


The relationship between electrogram cycle length and dominant frequency in patients with persistent atrial fibrillation.
MedLine Citation:
PMID:  19732234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Sites of complex fractionated atrial electrograms (CFAE) with a short mean cycle length (MCL) and sites with a high dominant frequency (DF) have been advocated as targets for ablation in patients with persistent atrial fibrillation (AF). However, there are little data on the relationship between theses 2 markers. This study assessed the relationship between the DF and electrogram MCL after pulmonary vein (PV) isolation in patients with persistent AF. METHODS AND RESULTS: A total of 44 patients with persistent AF were studied. Four-second bipolar electrograms were obtained with a multielectrode mapping catheter at regions throughout the left atrium after isolation of the pulmonary veins, with analysis of the MCL and DF at each site. The DF was defined as the largest frequency peak within a 2.5- to 16-Hz spectral profile generated with fast Fourier transformation of the electrogram. A total of 9,262 electrograms from the 44 patients were analyzed. The average MCL and DF post-PV isolation were 135 +/- 24 ms and 6.1 +/- 0.6 Hz, respectively. There was a statistically significant but weak correlation between the MCL and DF (r = 0.21, P < 0.001). Additionally, analysis of this relationship within each patient did not demonstrate a strong correlation (range of r values per patient =-0.18 to 0.47). CONCLUSIONS: There is a poor correlation between the electrogram MCL and DF in patients with persistent AF. Ablation strategies targeting DF and those targeting CFAE are therefore unlikely to direct ablation toward similar left atrial sites. Comparative studies are necessary to determine the effectiveness of each strategy in guiding catheter ablation of persistent AF.
Authors:
Sheldon M Singh; E Kevin Heist; Jacob S Koruth; Conor D Barrett; Jeremy N Ruskin; Moussa C Mansour
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Publication Detail:
Type:  Journal Article    
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:  1336-42     Citation Subset:  IM    
Affiliation:
Heart Center, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Atrial Fibrillation / diagnosis*
Body Surface Potential Mapping / methods*
Diagnosis, Computer-Assisted / methods*
Female
Humans
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Signal Processing, Computer-Assisted*

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


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