Relationship between complex fractionated atrial electrograms during atrial fibrillation and the critical site of atrial tachycardia that develops after catheter ablation for atrial fibrillation

Ji Eun Ban, Yung Lung Chen, Hwan Cheol Park, Hyun Soo Lee, Dae In Lee, Jongil Choi, Hong Euy Lim, Sang Weon Park, Young Hoon Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

CFAE and Development of AT After AF Ablation Introduction Complex fractionated atrial electrograms (CFAEs) are a substrate modification target in patients with atrial fibrillation (AF). However, whether CFAEs can be also arrhythmogenic grounds of atrial tachycardia (AT) presenting after AF ablation remains to be determined. We investigated the relationship between CFAEs and the critical site of AT after CFAE-guided AF ablation. Methods and Results Seventy-two patients showing AT after pulmonary vein isolation and further CFAE-guided ablation were included. The termination sites of the 95 distinct ATs were annotated on color-coded CFAE cycle maps. Of the 95 ATs, 61 (64.2%) had a termination site at the border zone of CFAE or in a highly dense CFAE area. The cycle length (CL) of the ATs terminated in the CFAE area was significantly shorter than the CL of those terminated in the non-CFAE area. The cut-off CL for ATs terminated at the CFAE area was 270 milliseconds, with sensitivity/ specificity of 70%/75%. In 67.2% of the ATs terminating at the CFAE-related area, the major termination sites were the anterior wall near the LA appendage, septum and roof, whereas the peri-mitral isthmus was the most common termination site of ATs in the non-CFAE area. Conclusions The areas showing CFAE and their border zones were frequently associated with termination of ATs presenting after AF ablation. The mean CL of ATs originating near CFAEs was significantly shorter than that of those terminated in non-CFAE areas. The targeted CFAE areas also provided the arrhythmogenic milieu for AT developing after AF ablation.

Original languageEnglish
Pages (from-to)146-153
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume25
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

Fingerprint

Cardiac Electrophysiologic Techniques
Catheter Ablation
Tachycardia
Atrial Fibrillation

Keywords

  • atrial fibrillation
  • atrial tachycardia
  • catheter ablation
  • complex fractionated atrial electrogram

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Relationship between complex fractionated atrial electrograms during atrial fibrillation and the critical site of atrial tachycardia that develops after catheter ablation for atrial fibrillation. / Ban, Ji Eun; Chen, Yung Lung; Park, Hwan Cheol; Lee, Hyun Soo; Lee, Dae In; Choi, Jongil; Lim, Hong Euy; Park, Sang Weon; Kim, Young Hoon.

In: Journal of Cardiovascular Electrophysiology, Vol. 25, No. 2, 01.02.2014, p. 146-153.

Research output: Contribution to journalArticle

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title = "Relationship between complex fractionated atrial electrograms during atrial fibrillation and the critical site of atrial tachycardia that develops after catheter ablation for atrial fibrillation",
abstract = "CFAE and Development of AT After AF Ablation Introduction Complex fractionated atrial electrograms (CFAEs) are a substrate modification target in patients with atrial fibrillation (AF). However, whether CFAEs can be also arrhythmogenic grounds of atrial tachycardia (AT) presenting after AF ablation remains to be determined. We investigated the relationship between CFAEs and the critical site of AT after CFAE-guided AF ablation. Methods and Results Seventy-two patients showing AT after pulmonary vein isolation and further CFAE-guided ablation were included. The termination sites of the 95 distinct ATs were annotated on color-coded CFAE cycle maps. Of the 95 ATs, 61 (64.2{\%}) had a termination site at the border zone of CFAE or in a highly dense CFAE area. The cycle length (CL) of the ATs terminated in the CFAE area was significantly shorter than the CL of those terminated in the non-CFAE area. The cut-off CL for ATs terminated at the CFAE area was 270 milliseconds, with sensitivity/ specificity of 70{\%}/75{\%}. In 67.2{\%} of the ATs terminating at the CFAE-related area, the major termination sites were the anterior wall near the LA appendage, septum and roof, whereas the peri-mitral isthmus was the most common termination site of ATs in the non-CFAE area. Conclusions The areas showing CFAE and their border zones were frequently associated with termination of ATs presenting after AF ablation. The mean CL of ATs originating near CFAEs was significantly shorter than that of those terminated in non-CFAE areas. The targeted CFAE areas also provided the arrhythmogenic milieu for AT developing after AF ablation.",
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T1 - Relationship between complex fractionated atrial electrograms during atrial fibrillation and the critical site of atrial tachycardia that develops after catheter ablation for atrial fibrillation

AU - Ban, Ji Eun

AU - Chen, Yung Lung

AU - Park, Hwan Cheol

AU - Lee, Hyun Soo

AU - Lee, Dae In

AU - Choi, Jongil

AU - Lim, Hong Euy

AU - Park, Sang Weon

AU - Kim, Young Hoon

PY - 2014/2/1

Y1 - 2014/2/1

N2 - CFAE and Development of AT After AF Ablation Introduction Complex fractionated atrial electrograms (CFAEs) are a substrate modification target in patients with atrial fibrillation (AF). However, whether CFAEs can be also arrhythmogenic grounds of atrial tachycardia (AT) presenting after AF ablation remains to be determined. We investigated the relationship between CFAEs and the critical site of AT after CFAE-guided AF ablation. Methods and Results Seventy-two patients showing AT after pulmonary vein isolation and further CFAE-guided ablation were included. The termination sites of the 95 distinct ATs were annotated on color-coded CFAE cycle maps. Of the 95 ATs, 61 (64.2%) had a termination site at the border zone of CFAE or in a highly dense CFAE area. The cycle length (CL) of the ATs terminated in the CFAE area was significantly shorter than the CL of those terminated in the non-CFAE area. The cut-off CL for ATs terminated at the CFAE area was 270 milliseconds, with sensitivity/ specificity of 70%/75%. In 67.2% of the ATs terminating at the CFAE-related area, the major termination sites were the anterior wall near the LA appendage, septum and roof, whereas the peri-mitral isthmus was the most common termination site of ATs in the non-CFAE area. Conclusions The areas showing CFAE and their border zones were frequently associated with termination of ATs presenting after AF ablation. The mean CL of ATs originating near CFAEs was significantly shorter than that of those terminated in non-CFAE areas. The targeted CFAE areas also provided the arrhythmogenic milieu for AT developing after AF ablation.

AB - CFAE and Development of AT After AF Ablation Introduction Complex fractionated atrial electrograms (CFAEs) are a substrate modification target in patients with atrial fibrillation (AF). However, whether CFAEs can be also arrhythmogenic grounds of atrial tachycardia (AT) presenting after AF ablation remains to be determined. We investigated the relationship between CFAEs and the critical site of AT after CFAE-guided AF ablation. Methods and Results Seventy-two patients showing AT after pulmonary vein isolation and further CFAE-guided ablation were included. The termination sites of the 95 distinct ATs were annotated on color-coded CFAE cycle maps. Of the 95 ATs, 61 (64.2%) had a termination site at the border zone of CFAE or in a highly dense CFAE area. The cycle length (CL) of the ATs terminated in the CFAE area was significantly shorter than the CL of those terminated in the non-CFAE area. The cut-off CL for ATs terminated at the CFAE area was 270 milliseconds, with sensitivity/ specificity of 70%/75%. In 67.2% of the ATs terminating at the CFAE-related area, the major termination sites were the anterior wall near the LA appendage, septum and roof, whereas the peri-mitral isthmus was the most common termination site of ATs in the non-CFAE area. Conclusions The areas showing CFAE and their border zones were frequently associated with termination of ATs presenting after AF ablation. The mean CL of ATs originating near CFAEs was significantly shorter than that of those terminated in non-CFAE areas. The targeted CFAE areas also provided the arrhythmogenic milieu for AT developing after AF ablation.

KW - atrial fibrillation

KW - atrial tachycardia

KW - catheter ablation

KW - complex fractionated atrial electrogram

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