Distinctive Patterns of Dominant Frequency Trajectory Behavior in Drug-Refractory Persistent Atrial Fibrillation: Preliminary Characterization of Spatiotemporal Instability.

Frequency Trajectory of Atrial Fibrillation Introduction The role of substrates in the maintenance of persistent atrial fibrillation (persAF) remains poorly understood. The use of dominant frequency (DF) mapping to guide catheter ablation has been proposed as a potential strategy, but the characteri...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 25; no. 4; pp. 371 - 380
Autores principales: Salinet, JoÃO L., Tuan, Jiun H., Sandilands, Alistair J., Stafford, Peter J., Schlindwein, Fernando S., AndrÉ Ng, G.
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Apr2014
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: Distinctive Patterns of Dominant Frequency Trajectory Behavior in Drug-Refractory Persistent Atrial Fibrillation: Preliminary Characterization of Spatiotemporal Instability.
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        au:
          Salinet, JoÃO L.
          Tuan, Jiun H.
          Sandilands, Alistair J.
          Stafford, Peter J.
          Schlindwein, Fernando S.
          AndrÉ Ng, G.
        affil: Department of Engineering, University of Leicester
      sug:
        subj:
          Atrial Fibrillation Pathology
          Catheter Ablation
          Atrial Fibrillation Therapy
          Drug Resistance
          Human
          Body Surface Potential Mapping
          Male
          Descriptive Statistics
          Adult
          Middle Age
          Electrophysiology
          Electrocardiography
          T-Tests
          Chi Square Test
          Fisher's Exact Test
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
      ab: Frequency Trajectory of Atrial Fibrillation Introduction The role of substrates in the maintenance of persistent atrial fibrillation (persAF) remains poorly understood. The use of dominant frequency (DF) mapping to guide catheter ablation has been proposed as a potential strategy, but the characteristics of high DF sites have not been extensively studied. This study aimed to assess the DF spatiotemporal stability using high density noncontact mapping (NCM) in persAF. Methods and Results Eight persAF patients were studied using NCM during AF. Ventricular far-field cancellation was performed followed by the calculation of DF using Fast Fourier Transform. Analysis of DF stability and spatiotemporal behavior were investigated including characteristics of the highest DF areas (HDFAs). A total of 16,384 virtual electrograms (VEGMs) and 232 sequential high density 3-dimensional DF maps were analyzed. The percentage of DF stable points decreased rapidly over time. Repetition or reappearance of DF values were noted in some instances, occurring within 10 seconds in most cases. Tracking the HDFAs' center of gravity revealed 3 types of propagation behavior, namely (i) local, (ii) cyclical, and (iii) chaotic activity, with the former 2 patterns accounting for most of the observed events. Conclusions DF of individual VEGMs was temporally unstable, although reappearance of DF values occurred at times. Hence, targeting sites of 'peak DF' from a single time frame is unlikely to be a reliable ablation strategy. There appears to be a predominance of local and cyclical activity of HDFAs hinting a potentially nonrandom temporally periodic behavior that provides further mechanistic insights into the maintenance of persAF.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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