Key result
Complex fractionated atrial electrogram ablation after standard pulmonary vein isolation did not significantly change dominant frequency (<0.25 Hz) or regulatory index (max 0.02 increase).
Why the study?
Does complex fractionated atrial electrogram (CFAE) ablation alter dominant frequency and regulatory index in patients undergoing ablation for atrial fibrillation?
Observational (n=41)
Does complex fractionated atrial electrogram (CFAE) ablation alter dominant frequency and regulatory index in patients undergoing ablation for atrial fibrillation?
p-value: p=not significant
CFAE ablation guided by automated software after standard PVI does not significantly influence the fibrillatory process compared to other standard ablation steps.
Acute CFAE effects on DF/RI are hypothesis-generating; larger trials needed before clinical adoption.
AIMS: The purpose of our study was to determine the acute effects of complex fractionated electrograms (CFAE) ablation guided by automated detection on dominant frequency (DF) and regulatory index (RI) for the fibrillatory process. METHODS AND RESULTS: The study included 41 patients (21 paroxysmal and 20 persistent) referred for catheter ablation of atrial fibrillation (AF). Our ablation strategy included pulmonary vein isolation (PVI) as first step, CFAE ablation as second step, roof line ablation as next, and mitral isthmus ablation as last step. On the CFAE map, we were targeting only points outside the previous PVI lines. Simultaneously, we evaluated DF and RI changes in the coronary sinus after each step of ablation. The termination rate by CFAE ablation was low (12.5% in paroxysmal and 10% in persistent AF). Changes in DF and RI after CFAE ablation were not significant (<0.25 Hz and max. 0.02 increase for RI) compared with other ablation steps. Pulmonary vein isolation, roof line, and mitral isthmus ablation resulted in significant changes in DF and RI. CONCLUSION: On the basis of our results, CFAE ablation guided by a dedicated software algorithm and performed after standard PVI without CFAE remapping does not influence the fibrillatory process significantly. Application of a modified algorithm with different settings warrants further investigations.
No takes yet. Share an insight, caveat, or question.
Bencsik et al. (2009) conducted an observational in Atrial fibrillation (n=41). Complex fractionated electrograms (CFAE) ablation vs. Other ablation steps (pulmonary vein isolation, roof line, and mitral isthmus ablation) was evaluated on Changes in dominant frequency (DF) and regulatory index (RI) (p=not significant). Complex fractionated atrial electrogram ablation after standard pulmonary vein isolation did not significantly change dominant frequency (<0.25 Hz) or regulatory index (max 0.02 increase).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: