Key result
In AF, ~61% of organized activation sites border or overlap low-voltage areas.
Why the study?
What is the spatial relationship between the standard deviation of complex fractionated atrial electrogram intervals and low-voltage areas in patients with atrial fibrillation?
Cross-Sectional (n=25)
No
What is the spatial relationship between the standard deviation of complex fractionated atrial electrogram intervals and low-voltage areas in patients with atrial fibrillation?
Answers are grounded in this paper and cite their sources.
Organized activation sites with small standard deviations of cycle length are mainly located at the periphery of low-voltage areas, suggesting these may represent sites of rotor or focal activity in atrial fibrillation.
Background: Rapid focal activity and rotor activity have been reported to play important roles in the maintenance of atrial fibrillation (AF).Identification of rotor/focal activity by spectral and phase analyses have been demonstrated.We hypothesized that if the drivers of AF are present, their characteristics may exhibit temporal stability rather than their voltage.Methods: In patients with paroxysmal AF (n = 18) and persistent AF (n = 7) LA mapping with a 20-pole spiral catheter was performed for 5 seconds during AF.Low voltage area (LVA during AF, < 0.2 mV), complex fragmented atrial electrogram (CFAE, cycle length < 120 ms) sites, and standard deviation (SD) of the cycle length were compared.Results: Smaller SD sites (< 20 ms) overlapped with LVAs at 11 sites (14%), were located adjacent to a LVA (within 15 mm from the LVA edge) at 36 sites (47%), and were located away from the LVA (> 15 mm from the LVA) at 29 sites (38%).Conclusion: Organized activation sites located mainly at the periphery of LVAs may represent sites of rotor/ focal activity.
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Takahashi et al. (2018) conducted a cross-sectional in Atrial Fibrillation (n=25). Small standard deviation (< 20 ms) of fractionation intervals was evaluated on Spatial relationship between small standard deviation sites and low-voltage areas. In patients with atrial fibrillation, organized activation sites with a small standard deviation of fractionation intervals (< 20 ms) were predominantly located adjacent to (47%) or overlapping (14%) low-voltage areas.
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