Regional fractionation and dominant frequency in persistent atrial fibrillation: effects of left atrial ablation and evidence of spatial relationship

Abstract

Left atrial ablation reduces global left atrial DF and decreases the degree of fractionation. Complex fractionated electrograms-mean and DF appear to share only modest spatial correlation and are affected to different extents by ablation, suggesting that they are either separate entities or reflect different components of the same substrate.

Contributing Factors Concerning Inconsistencies in Persistent Atrial Fibrillation Ablation Outcomes

“…The study population consisted of 18 persAF patients (16 male; mean age 56.1 ± 9.3 years; history of AF 67.2 ± 45.6 months) referred to our institution for first time catheter ablation [6]. Study approval was obtained from the local ethics committee and all procedures were performed with full informed consent.…”

“…PVI was performed followed by the creation of linear roof lines (PVI+RL) using a deflectable, variable loop circular mapping catheter (Inquiry Optima, St. Jude Medical). Bipolar AEGs were collected from 15 pre-determined atrial regions before and after LA ablation for each patient [6]. 797 AEGs (455 before and 342 after PVI+RL) were recorded from the LA (sampling frequency 1.2 kHz) and band-pass filtered (30 -300 Hz).…”

“…Inconsistencies between these algorithms could lead to discordant CFAE classifications by the available systems [4]. Additionally, while studies support that some CFAEs truly represent local AF drivers, others suggest CFAEs are resultant from distant AF drivers [5,6]. Finally, the spatio-temporal behavior of AEGs in persAF remains contentious [7].…”

Deterministic Structures in Fractionated Atrial Electrograms During Human Persistent Atrial Fibrillation

“…Details of the clinical characteristics of the study subjects and the mapping procedure have been provided elsewhere [14]. All patients were in AF at the start of the procedure.…”

Mapping of Atrial Fibrillation: Comparing Complex Fractionated Atrial Electrograms, Voltage Maps, Dominant Frequency Maps and Ganglionic Plexi

“…Areas most often harboring DF max sites include the interatrial septum, pulmonary veins, left atrial appendage, left atrial posterior wall and mitral annulus [30][31][32][33]. In PAF, DF max sites tend to cluster around the pulmonary veins; while in PeAF and more remodeled hearts, DF max sites are more evenly distributed across both atria [29][30][31][32].…”