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https://hdl.handle.net/2440/54030
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Type: | Journal article |
Title: | Characterization of electrograms associated with termination of chronic atrial fibrillation by catheter ablation |
Author: | Takahashi, Y. O'Neill, M. Hocini, M. Dubois, R. Matsuo, S. Knecht, S. Mahapatra, S. Lim, K. Jais, P. Jonsson, A. Sacher, F. Sanders, P. Rostock, T. Bordachar, P. Clementary, J. Klein, G. Haissaguerre, M. |
Citation: | Journal of the American College of Cardiology, 2008; 51(10):1003-1010 |
Publisher: | Elsevier Science Inc |
Issue Date: | 2008 |
ISSN: | 0735-1097 1558-3597 |
Statement of Responsibility: | Yoshihide Takahashi, Mark D. O’Neill, Mélèze Hocini, Rémi Dubois, Seiichiro Matsuo, Sébastien Knecht, Srijoy Mahapatra, Kang-Teng Lim, Pierre Jaïs, Anders Jonsson, Frédéric Sacher, Prashanthan Sanders, Thomas Rostock, Pierre Bordachar, Jacques Clémenty, George J. Klein and Michel Haïssaguerre |
Abstract: | <h4>Objectives</h4>This study sought to determine the characteristics of atrial electrograms predictive of slowing or termination of atrial fibrillation (AF) during ablation of chronic AF.<h4>Background</h4>There is growing recognition of a role for electrogram-based ablation.<h4>Methods</h4>Forty consecutive patients (34 male, 59 +/- 10 years) undergoing ablation for chronic AF persisting for a median of 12 months (range 1 to 84 months) were included. After pulmonary vein isolation and roof line ablation, electrogram-based ablation was performed in the left atrium and coronary sinus. Targeted electrograms were acquired in a 4-s window and characterized by: 1) percentage of continuous electrical activity; 2) bipolar voltage; 3) dominant frequency; 4) fractionation index; 5) mean absolute value of derivatives of electrograms; 6) local cycle length; and 7) presence of a temporal gradient of activation. Electrogram characteristics at favorable ablation regions, defined as those associated with slowing (a >or=6-ms increase in AF cycle length) or termination of AF were compared with those at unfavorable regions.<h4>Results</h4>The AF was terminated by electrogram-based ablation in 29 patients (73%) after targeting a total of 171 regions. Ablation at 37 (22%) of these regions was followed by AF slowing, and at 29 (17%) by AF termination. The percentage of continuous electrical activity and the presence of a temporal gradient of activation were independent predictors of favorable ablation regions (p = 0.016 and p = 0.038, respectively). Other electrogram characteristics at favorable ablation regions were not significantly different from those at unfavorable ablation regions.<h4>Conclusions</h4>Catheter ablation at sites displaying a greater percentage of continuous activity or a temporal activation gradient is associated with slowing or termination of chronic AF. |
Keywords: | Humans Heart Diseases Atrial Fibrillation Anti-Arrhythmia Agents Electrocardiography Electrophysiologic Techniques, Cardiac Catheter Ablation Middle Aged Female Male |
Description: | Copyright © 2008 by the American College of Cardiology Foundation Copyright © 2008 American College of Cardiology Foundation Published by Elsevier Inc. |
DOI: | 10.1016/j.jacc.2007.10.056 |
Description (link): | http://www.elsevier.com/wps/find/journaldescription.cws_home/505766/description#description |
Published version: | http://dx.doi.org/10.1016/j.jacc.2007.10.056 |
Appears in Collections: | Aurora harvest 5 Medicine publications |
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