Right Atrial Continuous Fractionated Electrograms in Patients with Long-Standing Persistent Atrial Fibrillation

Jongil Choi, Yae Min Park, Ji Eun Ban, Ra Seung Lim, Hyun Soo Lee, Kyoung Hee Lee, Nagamoto Yasutsugu, Jae Seung Jeong, Jae Seok Park, Hong Euy Lim, Sang Weon Park, Young Hoon Kim

Research output: Contribution to journalArticle

Abstract

Hypothesis: Continuous fractionated electrograms of the right atrium (RA-CFE) before ablation can predict clinical outcome of biatrial ablation. Methods: Consecutive 122 patients (56 ±9 years, 84% male) with longstanding persistent atrial fibrillation (AF) were enrolled. Catheter ablation at left atrium (LA) including electrical isolation of 4 pulmonary vein was performed in 70 patients (LA ablation), and electrograms-guided ablation at RA was performed in whom AF was not terminated after LA ablation (n=52, bi-atrial ablation). RA-CFE (+) was defined by >90 fractionation without isoelectric period for 30 seconds at crista terminalis and RA septum. Results: RA-CFE (+) at baseline was observed in 41.4% of LA ablation and in 67.3% of bi-atrial ablation group (p=0.006). Conversion rate to sinus rhythm by LA ablation was significantly lower in RA-CFE (+) than in RA-CFE (-) (69.0% vs 82.9%, p<0.001). During the mean 6-month, in patients with RA-CFE (+), freedom from recurrence was significantly higher in bi-atrial ablation than in LA ablation (71.4% vs 69.0%, p=0.009). RA-CFE (+) was associated with the recurrence after biatrial ablation (HR 3.646, 95% CI 1.288-10.324, p=0.015). Conclusions: RA ablation provides an increment in efficacy among patients with longstanding persistent AF who shows continuous fractionaed electrograms in RA. RA-CFE is a good predictor in identifying whom RA ablation for longstanding persistent AF is beneficial.

Original languageEnglish
Number of pages1
JournalJournal of Arrhythmia
Volume27
Issue number4
DOIs
Publication statusPublished - 2011 Jan 1

Fingerprint

Heart Atria
Atrial Fibrillation
Recurrence
Catheter Ablation
Pulmonary Veins

Keywords

  • atrial fibrillation
  • fractionated electrogram
  • right atrium

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Right Atrial Continuous Fractionated Electrograms in Patients with Long-Standing Persistent Atrial Fibrillation. / Choi, Jongil; Park, Yae Min; Ban, Ji Eun; Lim, Ra Seung; Lee, Hyun Soo; Lee, Kyoung Hee; Yasutsugu, Nagamoto; Jeong, Jae Seung; Park, Jae Seok; Lim, Hong Euy; Park, Sang Weon; Kim, Young Hoon.

In: Journal of Arrhythmia, Vol. 27, No. 4, 01.01.2011.

Research output: Contribution to journalArticle

Choi, J, Park, YM, Ban, JE, Lim, RS, Lee, HS, Lee, KH, Yasutsugu, N, Jeong, JS, Park, JS, Lim, HE, Park, SW & Kim, YH 2011, 'Right Atrial Continuous Fractionated Electrograms in Patients with Long-Standing Persistent Atrial Fibrillation', Journal of Arrhythmia, vol. 27, no. 4. https://doi.org/10.4020/jhrs.27.OP55_5
Choi, Jongil ; Park, Yae Min ; Ban, Ji Eun ; Lim, Ra Seung ; Lee, Hyun Soo ; Lee, Kyoung Hee ; Yasutsugu, Nagamoto ; Jeong, Jae Seung ; Park, Jae Seok ; Lim, Hong Euy ; Park, Sang Weon ; Kim, Young Hoon. / Right Atrial Continuous Fractionated Electrograms in Patients with Long-Standing Persistent Atrial Fibrillation. In: Journal of Arrhythmia. 2011 ; Vol. 27, No. 4.
@article{4467b6b05eba43cd92a55c6598d8e2f5,
title = "Right Atrial Continuous Fractionated Electrograms in Patients with Long-Standing Persistent Atrial Fibrillation",
abstract = "Hypothesis: Continuous fractionated electrograms of the right atrium (RA-CFE) before ablation can predict clinical outcome of biatrial ablation. Methods: Consecutive 122 patients (56 ±9 years, 84{\%} male) with longstanding persistent atrial fibrillation (AF) were enrolled. Catheter ablation at left atrium (LA) including electrical isolation of 4 pulmonary vein was performed in 70 patients (LA ablation), and electrograms-guided ablation at RA was performed in whom AF was not terminated after LA ablation (n=52, bi-atrial ablation). RA-CFE (+) was defined by >90 fractionation without isoelectric period for 30 seconds at crista terminalis and RA septum. Results: RA-CFE (+) at baseline was observed in 41.4{\%} of LA ablation and in 67.3{\%} of bi-atrial ablation group (p=0.006). Conversion rate to sinus rhythm by LA ablation was significantly lower in RA-CFE (+) than in RA-CFE (-) (69.0{\%} vs 82.9{\%}, p<0.001). During the mean 6-month, in patients with RA-CFE (+), freedom from recurrence was significantly higher in bi-atrial ablation than in LA ablation (71.4{\%} vs 69.0{\%}, p=0.009). RA-CFE (+) was associated with the recurrence after biatrial ablation (HR 3.646, 95{\%} CI 1.288-10.324, p=0.015). Conclusions: RA ablation provides an increment in efficacy among patients with longstanding persistent AF who shows continuous fractionaed electrograms in RA. RA-CFE is a good predictor in identifying whom RA ablation for longstanding persistent AF is beneficial.",
keywords = "atrial fibrillation, fractionated electrogram, right atrium",
author = "Jongil Choi and Park, {Yae Min} and Ban, {Ji Eun} and Lim, {Ra Seung} and Lee, {Hyun Soo} and Lee, {Kyoung Hee} and Nagamoto Yasutsugu and Jeong, {Jae Seung} and Park, {Jae Seok} and Lim, {Hong Euy} and Park, {Sang Weon} and Kim, {Young Hoon}",
year = "2011",
month = "1",
day = "1",
doi = "10.4020/jhrs.27.OP55_5",
language = "English",
volume = "27",
journal = "Journal of Arrhythmia",
issn = "1880-4276",
publisher = "Elsevier BV",
number = "4",

}

TY - JOUR

T1 - Right Atrial Continuous Fractionated Electrograms in Patients with Long-Standing Persistent Atrial Fibrillation

AU - Choi, Jongil

AU - Park, Yae Min

AU - Ban, Ji Eun

AU - Lim, Ra Seung

AU - Lee, Hyun Soo

AU - Lee, Kyoung Hee

AU - Yasutsugu, Nagamoto

AU - Jeong, Jae Seung

AU - Park, Jae Seok

AU - Lim, Hong Euy

AU - Park, Sang Weon

AU - Kim, Young Hoon

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Hypothesis: Continuous fractionated electrograms of the right atrium (RA-CFE) before ablation can predict clinical outcome of biatrial ablation. Methods: Consecutive 122 patients (56 ±9 years, 84% male) with longstanding persistent atrial fibrillation (AF) were enrolled. Catheter ablation at left atrium (LA) including electrical isolation of 4 pulmonary vein was performed in 70 patients (LA ablation), and electrograms-guided ablation at RA was performed in whom AF was not terminated after LA ablation (n=52, bi-atrial ablation). RA-CFE (+) was defined by >90 fractionation without isoelectric period for 30 seconds at crista terminalis and RA septum. Results: RA-CFE (+) at baseline was observed in 41.4% of LA ablation and in 67.3% of bi-atrial ablation group (p=0.006). Conversion rate to sinus rhythm by LA ablation was significantly lower in RA-CFE (+) than in RA-CFE (-) (69.0% vs 82.9%, p<0.001). During the mean 6-month, in patients with RA-CFE (+), freedom from recurrence was significantly higher in bi-atrial ablation than in LA ablation (71.4% vs 69.0%, p=0.009). RA-CFE (+) was associated with the recurrence after biatrial ablation (HR 3.646, 95% CI 1.288-10.324, p=0.015). Conclusions: RA ablation provides an increment in efficacy among patients with longstanding persistent AF who shows continuous fractionaed electrograms in RA. RA-CFE is a good predictor in identifying whom RA ablation for longstanding persistent AF is beneficial.

AB - Hypothesis: Continuous fractionated electrograms of the right atrium (RA-CFE) before ablation can predict clinical outcome of biatrial ablation. Methods: Consecutive 122 patients (56 ±9 years, 84% male) with longstanding persistent atrial fibrillation (AF) were enrolled. Catheter ablation at left atrium (LA) including electrical isolation of 4 pulmonary vein was performed in 70 patients (LA ablation), and electrograms-guided ablation at RA was performed in whom AF was not terminated after LA ablation (n=52, bi-atrial ablation). RA-CFE (+) was defined by >90 fractionation without isoelectric period for 30 seconds at crista terminalis and RA septum. Results: RA-CFE (+) at baseline was observed in 41.4% of LA ablation and in 67.3% of bi-atrial ablation group (p=0.006). Conversion rate to sinus rhythm by LA ablation was significantly lower in RA-CFE (+) than in RA-CFE (-) (69.0% vs 82.9%, p<0.001). During the mean 6-month, in patients with RA-CFE (+), freedom from recurrence was significantly higher in bi-atrial ablation than in LA ablation (71.4% vs 69.0%, p=0.009). RA-CFE (+) was associated with the recurrence after biatrial ablation (HR 3.646, 95% CI 1.288-10.324, p=0.015). Conclusions: RA ablation provides an increment in efficacy among patients with longstanding persistent AF who shows continuous fractionaed electrograms in RA. RA-CFE is a good predictor in identifying whom RA ablation for longstanding persistent AF is beneficial.

KW - atrial fibrillation

KW - fractionated electrogram

KW - right atrium

UR - http://www.scopus.com/inward/record.url?scp=85009580693&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85009580693&partnerID=8YFLogxK

U2 - 10.4020/jhrs.27.OP55_5

DO - 10.4020/jhrs.27.OP55_5

M3 - Article

AN - SCOPUS:85009580693

VL - 27

JO - Journal of Arrhythmia

JF - Journal of Arrhythmia

SN - 1880-4276

IS - 4

ER -