Spatial Relations between the Standard Deviation of Complex Fractionated Atrial Electrogram Intervals and Low-Voltage Areas in Patients with Atrial Fibrillation

抄録

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.