Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation
Abstract Background The impact of left atrial posterior wall isolation (LAPWI) on the complex fractionated atrial electrogram (CFAE) is unknown. Methods CFAE mapping was performed before and after LAPWI in 46 patients with persistent atrial fibrillation (AF). Results LAPWI decreased both the variabl...
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doaj-78e8ed759624463d863b24140f5c88302020-11-25T01:04:33ZengWileyJournal of Arrhythmia1880-42761883-21482019-06-0135352853410.1002/joa3.12182Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillationYosuke Nakatani0Tamotsu Sakamoto1Yoshiaki Yamaguchi2Yasushi Tsujino3Naoya Kataoka4Kunihiro Nishida5Koichi Mizumaki6Koichiro Kinugawa7Second Department of Internal Medicine University of Toyama Toyama JapanSecond Department of Internal Medicine University of Toyama Toyama JapanSecond Department of Internal Medicine University of Toyama Toyama JapanSecond Department of Internal Medicine University of Toyama Toyama JapanSecond Department of Internal Medicine University of Toyama Toyama JapanNishida Medical Clinic Toyama JapanAlpen Murotani Clinic Toyama JapanSecond Department of Internal Medicine University of Toyama Toyama JapanAbstract Background The impact of left atrial posterior wall isolation (LAPWI) on the complex fractionated atrial electrogram (CFAE) is unknown. Methods CFAE mapping was performed before and after LAPWI in 46 patients with persistent atrial fibrillation (AF). Results LAPWI decreased both the variable (fractionated index ≤ 120 ms; from 60 ± 4 cm2 to 50 ± 4 cm2, P < 0.001) and continuous (fractionated index ≤ 50 ms; from 4.2 ± 1.0 cm2 to 3.5 ± 0.9 cm2, P = 0.036) CFAE areas. Especially, the CFAE areas on the bottom and roof walls of the left atrium and on the posterior and bottom walls of the right atrium significantly decreased after LAPWI. The distribution of variable CFAE areas was not different between the AF‐recurrence (n = 9) and AF‐free (n = 37) groups before LAPWI; however, it was larger in the anterior and septal walls of the right atrium in the AF‐recurrence group than in the AF‐free group after LAPWI (anterior wall, 8% ± 2% vs 5% ± 1%, P = 0.048; septal wall, 23% ± 4% vs 16% ± 1%, P = 0.043). The distribution of continuous CFAE areas on the bottom wall of the right atrium was larger in the AF‐recurrence group than in the AF‐free group both before LAPWI (30% ± 20% vs 4% ± 2%, P = 0.008) and after LAPWI (25% ± 25% vs 3% ± 1%, P = 0.027). Conclusions LAPWI decreased the CFAE areas and affected their distribution, which contributed to AF recurrence.https://doi.org/10.1002/joa3.12182atrial fibrillationcatheter ablationcomplex fractionated atrial electrogramleft atrial posterior wall isolationpulmonary vein isolation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yosuke Nakatani Tamotsu Sakamoto Yoshiaki Yamaguchi Yasushi Tsujino Naoya Kataoka Kunihiro Nishida Koichi Mizumaki Koichiro Kinugawa |
spellingShingle |
Yosuke Nakatani Tamotsu Sakamoto Yoshiaki Yamaguchi Yasushi Tsujino Naoya Kataoka Kunihiro Nishida Koichi Mizumaki Koichiro Kinugawa Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation Journal of Arrhythmia atrial fibrillation catheter ablation complex fractionated atrial electrogram left atrial posterior wall isolation pulmonary vein isolation |
author_facet |
Yosuke Nakatani Tamotsu Sakamoto Yoshiaki Yamaguchi Yasushi Tsujino Naoya Kataoka Kunihiro Nishida Koichi Mizumaki Koichiro Kinugawa |
author_sort |
Yosuke Nakatani |
title |
Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation |
title_short |
Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation |
title_full |
Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation |
title_fullStr |
Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation |
title_full_unstemmed |
Left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation |
title_sort |
left atrial posterior wall isolation affects complex fractionated atrial electrograms in persistent atrial fibrillation |
publisher |
Wiley |
series |
Journal of Arrhythmia |
issn |
1880-4276 1883-2148 |
publishDate |
2019-06-01 |
description |
Abstract Background The impact of left atrial posterior wall isolation (LAPWI) on the complex fractionated atrial electrogram (CFAE) is unknown. Methods CFAE mapping was performed before and after LAPWI in 46 patients with persistent atrial fibrillation (AF). Results LAPWI decreased both the variable (fractionated index ≤ 120 ms; from 60 ± 4 cm2 to 50 ± 4 cm2, P < 0.001) and continuous (fractionated index ≤ 50 ms; from 4.2 ± 1.0 cm2 to 3.5 ± 0.9 cm2, P = 0.036) CFAE areas. Especially, the CFAE areas on the bottom and roof walls of the left atrium and on the posterior and bottom walls of the right atrium significantly decreased after LAPWI. The distribution of variable CFAE areas was not different between the AF‐recurrence (n = 9) and AF‐free (n = 37) groups before LAPWI; however, it was larger in the anterior and septal walls of the right atrium in the AF‐recurrence group than in the AF‐free group after LAPWI (anterior wall, 8% ± 2% vs 5% ± 1%, P = 0.048; septal wall, 23% ± 4% vs 16% ± 1%, P = 0.043). The distribution of continuous CFAE areas on the bottom wall of the right atrium was larger in the AF‐recurrence group than in the AF‐free group both before LAPWI (30% ± 20% vs 4% ± 2%, P = 0.008) and after LAPWI (25% ± 25% vs 3% ± 1%, P = 0.027). Conclusions LAPWI decreased the CFAE areas and affected their distribution, which contributed to AF recurrence. |
topic |
atrial fibrillation catheter ablation complex fractionated atrial electrogram left atrial posterior wall isolation pulmonary vein isolation |
url |
https://doi.org/10.1002/joa3.12182 |
work_keys_str_mv |
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