Key result
CFAE sites show high spatiotemporal stability during mapping, unlike high DF sites.
Why the study?
Are complex fractionated atrial electrograms and high dominant frequencies spatiotemporally stable during atrial fibrillation mapping?
Observational (n=36)
Are complex fractionated atrial electrograms and high dominant frequencies spatiotemporally stable during atrial fibrillation mapping?
CFAE sites demonstrate high spatial and temporal stability during AF mapping, unlike high dominant frequency sites, suggesting CFAEs may be a more reliable mapping target.
May support CFAE-guided AF ablation; leaves open outcome benefit versus DF in randomized trials.
Background The presence of complex fractionated atrial electrograms (CFAEs) and high dominant frequencies (DFs) during atrial fibrillation (AF) have been demonstrated to be related to AF maintenance. Therefore, sequential mapping of CFAEs and DFs have been used for target sites of AF ablation. However, such mapping strategies are valid only if the CFAEs and DFs are spatiotemporally stable during the mapping procedure. We obtained spatially stable multi‐electrode recordings to assess the spatiotemporal stability of CFAEs and DFs. Methods We recorded electrical activity during AF for 10 min with a 64‐electrode basket catheter (48 bipole electrode pairs) placed in the left atrium in 36 patients with AF (paroxysmal AF [PAF], n =16; persistent AF [PerAF], n =20). The spatial and temporal distribution of the CFAEs (fractionation interval <120 ms) and high DFs (>8 Hz) at 1‐min intervals for 10 min were compared for each of the 48 bipoles. Results The baseline CFAEs were located at 68.5±14.0% (32.9±6.7) of the 48 bipoles; however, the high DF sites were fewer (9.6±8.6% [4.6±4.1 bipoles]). The CFAEs sites did not change significantly during the 10‐min recording period (kappa statistic: 0.71±0.24); however, the high DF sites changed significantly (kappa statistic: 0.07±0.19). These spatiotemporal changes in the CFAEs and high DFs did not differ between patients with PAF and PerAF. Conclusions Regardless of the AF type, CFAEs sites, but not high DF sites, showed a high degree of spatial and temporal stability.
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Kogawa et al. (2014) conducted an observational in Atrial fibrillation (n=36). 64-electrode basket catheter mapping was evaluated on Spatial and temporal distribution and stability of CFAEs and high DFs. Complex fractionated atrial electrogram sites showed high spatiotemporal stability (kappa 0.71±0.24) during 10-minute mapping, whereas high dominant frequency sites did not (kappa 0.07±0.19).
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