Long- and short-term temporal stability of complex fractionated atrial electrograms in human left atrium during atrial fibrillation.
Background: Complex fractionated atrial electrograms (CFAEs) have been reported as targets for catheter ablation of atrial fibrillation (AF). However, the temporal stability of CFAE sites remains poorly defined. Methods and Results: The study consisted of two phases. In the initial phase, two automa...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 20; no. 1; pp. 13 - 22 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | pictorial research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105604540&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105604540 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jan2009 vid: 20 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105604540 2010143239 10.1111/j.1540-8167.2008.01278.x NLM18775047 105604540 ppf: 13 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Long- and short-term temporal stability of complex fractionated atrial electrograms in human left atrium during atrial fibrillation. aug: au: Scherr D Dalal D Cheema A Nazarian S Almasry I Bilchick K Cheng A Henrikson CA Spragg D Marine JE Berger RD Calkins H Dong J affil: Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA sug: subj: Atrial Fibrillation Physiopathology Atrial Fibrillation Surgery Catheter Ablation Methods Electrocardiography Methods Therapy, Computer Assisted Adult Algorithms Body Surface Potential Mapping Confidence Intervals Data Analysis Software Female Funding Source kappa Statistic Male Middle Age One-Way Analysis of Variance Paired T-Tests ROC Curve Sensitivity and Specificity Software Validation Studies Human Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background: Complex fractionated atrial electrograms (CFAEs) have been reported as targets for catheter ablation of atrial fibrillation (AF). However, the temporal stability of CFAE sites remains poorly defined. Methods and Results: The study consisted of two phases. In the initial phase, two automated software algorithms, namely the interval confidence level (ICL) and the average interpotential interval (AIPI) were assessed for their diagnostic accuracy for automated CFAE detection. The AIPI was found to be superior to the ICL, and an AIPI of <=100 ms was associated with a sensitivity and specificity of both 92% for detection of CFAEs. In the second phase of the study, 12 patients (2 females, mean age 54 ± 12 years) who underwent catheter ablation for persistent AF were studied to investigate the temporal stability of CFAEs. Two consecutive left atrial (LA) three-dimensional CFAE maps coded with AIPI readings were reconstructed during ongoing AF in each study patient, with a mean time difference of 34.3 ± 8.7 minutes between the two maps. Among a total of 149 CFAE sites and 238 non-CFAE sites on the first CFAE map that were precisely revisited during the repeat mapping process, 135 (90.6%) and 225 (94.5%) remained as CFAE sites and non-CFAE sites, respectively. RF ablation at the selected stable CFAE sites significantly prolonged AF cycle length (181 ± 26 ms to 199 ± 29 ms, P < 0.0001). Conclusion: CFAEs recorded in the LA during AF display high temporal stability in patients with persistent AF. The clinical significance of our findings warrants further investigation. pubtype: Academic Journal doctype: pictorial research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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