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Is There a Relationship Between Complex Fractionated Atrial Electrograms Recorded During Atrial Fibrillation and Sinus Rhythm Fractionation?
MedLine Citation:
PMID:  21946341     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Ablation of persistent atrial fibrillation (AF) may require adjunctive methods of substrate modification. Both ablation targeting complex fractionated atrial electrograms (CFAE) recorded during AF and fractionated electrograms recorded during sinus rhythm (SRF) have been described. However, the relationship of CFAE to SRF is unclear. METHODS: Twenty patients (age 62±9 yrs, 13 male) with persistent AF and 9 control subjects without organic heart disease or AF (age 36±6, 4 male) underwent detailed CFAE and SRF left atrial (LA) electroanatomic maps. The overlap in left atrial regions with CFAE and SRF were compared in the AF population, and the distribution of SRF was compared among AF patients and normal controls. Propagation maps were analyzed to identify activation patterns associated with SR fractionation. RESULTS: SRF (338±150 points) and CFAE (418±135 points) regions comprised 29±14 and 25±15 % of the LA surface area, respectively. There was no significant correlation between SRF and CFAE maps (r=0.2, P=NS). Comparing AF patients and controls, there was no significant difference in the distribution of SRF between groups (p=0.74). Regions of SRF overlapped areas of wavefront collision 75±13% of the time. CONCLUSIONS: 1) There is little overlap between regions of CFAE during AF and regions of SR fractionation measured in the time or frequency domain 2) the majority of SRF appears to occur in regions with wavefront collision, 3) the distribution of SRF is similar in normal controls suggesting this may not have an important role in AF maintenance and may not be a suitable ablation target.
Authors:
Laszlo Saghy; David J Callans; Fermin Garcia; David Lin; Francis E Marchlinski; Michael Riley; Sanjay Dixit; Wendy S Tzou; Harris M Haqqani; Robert Pap; Steven Kim; Edward P Gerstenfeld
Publication Detail:
Type:  -     Date:  2011-9-22
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
2(nd) Department of Medicine and Cardiology Center, University of Szeged, Hungary.
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