Endocardial Fragmented Electrogram and Prediction of Ventricular Tachycardia by Body Surface Signal‐Averaged Electrocardiographic Mapping

Sasaki, Yasuyuki; Furihata, Akiko; Suyama, Kazuhiro

doi:10.1111/j.1540-8159.1995.tb06734.x

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…Other studies have demonstrated a strong correlation between fractionated endocardial electrograms and AF episodes 33,34 . Fragmented ventricular activation detected by endocardial electrograms has been already correlated with low-amplitude and high-frequency signals detected on body surface SAECG 35,36 . Thus, it is reasonable to conclude that the spectral turbulence of the surface P-SAECG reflects the presence of potential fragmented intracavitary atrial activation.…”

Section: (B) Mec (%) (C) Sec (%) (D) Met (Hz) (E) Set (Hz)mentioning

confidence: 99%

Remodelagem atrial elétrica reversa após cardioversão de fibrilação atrial isolada de longa duração

Barbosa¹,

Benchimol-Barbosa²,

Bomfim³

et al. 2009

Arq. Bras. Cardiol.

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Background: Atrial fibrillation (AF) itself promotes electrophysiological changes, termed "electrical remodeling", facilitating its recurrence and maintenance. There is evidence that the remodeling process is reversible after restoration of the sinus rhythm (SR). However, the timing for the recovery of electrophysiological properties is still undefined.Objctive: The aim of this study was to assess the atrial electrical activation using P-wave signal-averaged electrocardiogram (P-SAECG) post-cardioversion of long-standing AF, focusing on the reversal remodeling process to identify the timing of the process stabilization.Methods: Subjects with lone persistent AF, eligible for cardioversion and successfully converted to SR, were enrolled at the study. SAECG was performed immediately after reversion to SR and repeated on days seven and thirty.Results: Of 31 subjects, nine presented early recurrence of atrial fibrillation, all of them in the first seven days postcardioversion; 22 remained in SR for at last one month and SAECG was obtained on days seven and thirty after cardioversion. In the latter, P-wave duration progressively abated from the first to the third SAECG (P-wave duration: 185.5±41.9 ms vs 171.7±40.5 ms vs 156.7±34.9 ms, respectively, first, second and third SAECG; p<0.001 for all matches). In the frequency domain analysis, spectral turbulence was not apparent in SAECG immediately postcardioversion, but sharply increased on day seven and remained unchanged on day thirty. Conclusion IntroductionAtrial fibrillation (AF) has been described as a selfperpetuating arrhythmia, which promotes electrophysiological changes in atrial tissue, facilitating its recurrence and maintenance [1][2][3][4][5] . Persistent AF usually progresses to a permanent form and the successful restoration and maintenance of sinus rhythm largely depend on arrhythmia duration, with longstanding AF being more resistant to cardioversion and more prone to recurrence [6][7][8][9] . Both resistance to cardioversion and tendency of recurrence are strongly related to the development of electrophysiological substrates characterized by shortened atrial effective refractory period 2,4,5,[10][11][12][13] , slow conduction in the atrial myocardium 10,11,[14][15][16] and dispersion of refractoriness 4,13,17,18 . These changes can be induced by both rapid atrial pacing and AF itself, and have been termed "electrical remodeling" 2 . The resultant electrophysiological abnormality is the presence of multiple wavelets around the atria, some of which circle back on them creating multiples reentry circuits, as proposed by Moe et al 19,20 in 1962 and 1964, and later confirmed by Allessie et al 21 in 1985.In animal models, the remodeling process has been demonstrated to be reversible after restoration of the sinus rhythm, and is characterized by progressive increase in both atrial conduction velocity and refractoriness (reversal remodeling) 1,2,10,11,13,22 . Recovery has also been demonstrated in human atria 3,[23][24][25][26] . On the other hand, a remarkab...

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Section: (B) Mec (%) (C) Sec (%) (D) Met (Hz) (E) Set (Hz)mentioning

confidence: 99%

Remodelagem atrial elétrica reversa após cardioversão de fibrilação atrial isolada de longa duração

Barbosa¹,

Benchimol-Barbosa²,

Bomfim³

et al. 2009

Arq. Bras. Cardiol.

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“…These tissues serve as a substrate for ventricular arrhythmias in 15% of cases, which increases the risk of sudden and non-sudden death by six-fold when compared to patients with a comparable ejection fraction without LVA. [11][12][13][14][15] It may also cause significant loss of stroke volume and may be responsible for the congestive heart failure, which is encountered in half of these patients. Thus LVA is associated with significant morbidity and mortality.…”

mentioning

confidence: 99%

“…The wall of the LVA consists of fibrous tissue as well as necrotic myocardium with islands of viable but ischemic myocardium. These tissues serve as a substrate for ventricular arrhythmias in 15% of cases, which increases the risk of sudden and non‐sudden death by six‐fold when compared to patients with a comparable ejection fraction without LVA 11–15 . It may also cause significant loss of stroke volume and may be responsible for the congestive heart failure, which is encountered in half of these patients.…”

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confidence: 99%

Fragmented Left Sided QRS in Absence of Bundle Branch Block: Sign of Left Ventricular Aneurysm

Reddy

Cheriparambill

Saul

et al. 2006

Noninvasive Electrocardiol

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Magnetokardiographische Spätfelddiagnostik. Gegenwärtiger Stand und Entwicklungsperspektiven

Weismüller

1997

Herzschr Elektrophys

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The occurence of ventricular late potentials in the signal averaged surface ECG is an indicator for slow electrical excitation in myocardial tissue prone to arrhythmias. Signal averaged surface ECG is performed for identification of patients with ventricular late potentials who have a high risk for life threatening arrhythmias. Since every electrical field is combined with a magnetic field, established methods of the signal averaged surface ECG were applied on recorded magnetocardiograms of patients. The incidences and details of late ventricular activity in the signal averaged electrocardiogram (ventricular late potentials) were compared with those in the magnetocardiogram (ventricular late fields). A close correlation of the two different methods was found. The magnetocardiogram has the option for the determination of the site of origin of magnetic signals three-dimensionally. In the future, this method may help to find areas of slow conduction for ablative procedures to cure patients with a high risk for malignant arrhythmias.

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Endocardial Fragmented Electrogram and Prediction of Ventricular Tachycardia by Body Surface Signal‐Averaged Electrocardiographic Mapping

Cited by 6 publications

References 10 publications

Remodelagem atrial elétrica reversa após cardioversão de fibrilação atrial isolada de longa duração

Remodelagem atrial elétrica reversa após cardioversão de fibrilação atrial isolada de longa duração

Fragmented Left Sided QRS in Absence of Bundle Branch Block: Sign of Left Ventricular Aneurysm

Magnetokardiographische Spätfelddiagnostik. Gegenwärtiger Stand und Entwicklungsperspektiven

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