Journal of Interventional Cardiac Electrophysiology

, Volume 28, Issue 2, pp 87–93

Characteristics and distribution of complex fractionated atrial electrograms in patients with paroxysmal and persistent atrial fibrillation

Authors

    • Department of Heart DiseaseHaukeland University Hospital
    • Institute of MedicineUniversity of Bergen
  • Morten Kristian Off
    • Department of Heart DiseaseHaukeland University Hospital
  • Per Ivar Hoff
    • Department of Heart DiseaseHaukeland University Hospital
  • Peter Schuster
    • Department of Heart DiseaseHaukeland University Hospital
    • Institute of MedicineUniversity of Bergen
  • Ole-Jørgen Ohm
    • Institute of MedicineUniversity of Bergen
  • Jian Chen
    • Department of Heart DiseaseHaukeland University Hospital
    • Institute of MedicineUniversity of Bergen
Article

DOI: 10.1007/s10840-010-9479-3

Cite this article as:
Solheim, E., Off, M.K., Hoff, P.I. et al. J Interv Card Electrophysiol (2010) 28: 87. doi:10.1007/s10840-010-9479-3

Abstract

Introduction

Substrate-based radiofrequency ablation for treatment of atrial fibrillation (AF) is still under development. The purpose of this study was to investigate the different characteristics and distribution of complex fractionated atrial electrograms (CFAE) in both atria in patients with paroxysmal and persistent AF.

Methods and Results

The NavX™ system was used to map the left and right atria and the coronary sinus in 20 AF patients (ten persistent). An automated algorithm calculates the average time interval between consecutive deflections (complex fractionated electrogram (CFE) mean). All recordings were visually inspected off-line and interpreted either as continuous, fragmented, mixed CFAE, or non-CFAE, and their locations were determined. Electrograms with intermittent CFAE characteristics were also regarded as non-CFAEs. There were more CFAEs in persistent AF than in paroxysmal AF (52% vs. 44% of total registrations, p < 0.05), and CFAEs were more widespread in both atria in persistent AF patients. There were also more continuous CFAEs (70% vs. 59% of total CFAEs, p < 0.05), and less mixed and intermittent CFAEs (22% vs. 30% and 16% vs. 21% of total CFAEs, respectively, p < 0.05) in persistent AF. Fragmented CFAEs had more high-voltage signals than other groups. Employing the automated algorithm for CFAE mapping, a CFE mean cut-off value of ≤80 ms provides a sensitivity and specificity of 87.4% and 81.2%, respectively.

Conclusions

CFAEs distribute in preferential areas and arrange in different patterns in both atria. Patients with persistent AF have more continuous CFAEs and higher temporal signal stability than patients with paroxysmal AF.

Keywords

Atrial fibrillationMappingComplex fractionated atrial electrograms

Copyright information

© Springer Science+Business Media, LLC 2010