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June 1, 2018Circulation Arrhythmia and ElectrophysiologyOpen Access

Two mapping methods similarly detect rotational or focal patterns at persistent AF termination sites.

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Population

55 patients with persistent AF in whom ablation terminated AF prior to pulmonary vein isolation, mean age…

Design

Cohort

Key result

Global mapping of persistent AF revealed that sites of AF termination showed rotational or focal patterns by two mapping methods in 92.7% vs 100% of patients (P=0.13).

Authors

CKChristopher KowalewskiFSFatemah ShenasaMRMiguel Rodrigo

Discussion

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Overview

Mapping may identify conserved termination sites in persistent AF; leaves open whether targeted ablation improves outcomes in trials.

Study Design

Type

Observational (n=55)

Multicenter

Yes

Structured PICO

P
Population
55 patients with persistent AF in whom ablation terminated AF prior to pulmonary vein isolation, mean age 62.2±9.7 years, 76% male, from a multicenter registry.
I
Intervention
Global AF mapping using electrograms for 360±45 cycles via two methods: (1) a published phase method and (2) a commercial activation/phase method.
O
Outcome
Detection of rotational/focal patterns at sites of AF termination and temporal fluctuation of organized regionssurrogate

Main Result

Absolute Event Rate: 92.7% vs 100%

p-value: p=0.13

In persistent AF, sites where ablation terminates the arrhythmia show organized activation that fluctuates over time but recurs in conserved spatial regions, requiring 8 to 32 seconds of recording for reliable detection.

Cite This Study

Kowalewski et al. (2018) conducted an observational in Persistent atrial fibrillation (n=55). Global mapping using published phase method vs. Commercial activation/phase method was evaluated on Detection of rotational/focal patterns at sites of AF termination (p=0.13). Global mapping of persistent AF revealed that sites of AF termination showed rotational or focal patterns by two mapping methods in 92.7% vs 100% of patients (P=0.13).

synapsesocial.com/papers/6a0d2909d7cdc72b86656693https://doi.org/10.1161/circep.117.005846
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Wavefront Field Mapping Reveals a Physiologic Network Between Drivers Where Ablation Terminates Atrial Fibrillation2019 · 11 citations
  2. 2Identification and Characterization of Sites Where Persistent Atrial Fibrillation Is Terminated by Localized Ablation2018 · 60 citations
  3. 3Driver Domains in Persistent Atrial Fibrillation2014 · 733 citations
  4. 4Termination of persistent atrial fibrillation by ablating sites that control large atrial areas2020 · 17 citations
  5. 5Localized Sources Maintaining Atrial Fibrillation Organized by Prior Ablation2006 · 232 citations