Severe and uniform bi-atrial remodeling measured by dominant frequency analysis in persistent atrial fibrillation unresponsive to ablation.

Details

Serval ID
serval:BIB_888860D9EF80
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Severe and uniform bi-atrial remodeling measured by dominant frequency analysis in persistent atrial fibrillation unresponsive to ablation.
Journal
Journal of interventional cardiac electrophysiology
Author(s)
Luca A., Pittet A., Buttu A., McCann A., Vesin J.M., Pascale P., Le Bloa M., Herrera C., Park C.I., Rollin A., Maury P., Roten L., Kühne M., Spies F., Knecht S., Sticherling C., Pruvot E.
ISSN
1572-8595 (Electronic)
ISSN-L
1383-875X
Publication state
Published
Issued date
11/2020
Peer-reviewed
Oui
Volume
59
Number
2
Pages
431-440
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
High values of ECG and intracardiac dominant frequency (DF) are indicative of significant atrial remodeling in persistent atrial fibrillation (peAF). We hypothesized that patients with peAF unresponsive to ablation display higher ECG and intracardiac DFs than those remaining in sinus rhythm (SR) on the long term.
Forty consecutive patients underwent stepwise ablation for peAF (sustained duration 19 ± 11 months). Electrograms were recorded before ablation at 13 left atrium (LA) sites and at the right atrial appendage (RAA) and coronary sinus (CS) synchronously to the ECG. DF was defined as the highest peak within the power spectrum.
peAF was terminated within the LA in 28 patients (left-terminated [LT]), whereas 12 patients remaining in AF after ablation (not left-terminated [NLT]) were cardioverted. Over a mean follow-up of 34 ± 14 months, all 12 NLT patients had a recurrence. Of the LT patients, 71% had a recurrence (20/28, LT_Rec), while 29% remained in SR throughout the follow-up (8/28, LT_SR). DF values and correlations between pairs of LA appendage (LAA), RAA, and CS DFs showed distinctive patterns among the subgroups. The NLT subgroup displayed the highest ECG and intracardiac DFs, with strong intragroup homogeneity between pairs of CS and LAA DFs, and to a lesser extent between pairs of CS and RAA DFs. Conversely, the LT_SR subgroup showed the lowest DFs, with significant intragroup heterogeneity between pairs of CS and both LAA and RAA DFs.
Patients with peAF unresponsive to ablation show high surface and intracardiac DFs indicative of severe and uniform bi-atrial remodeling.
Keywords
Atrial fibrillation, Catheter ablation, Dominant frequency, Electroanatomical remodeling, Intracardiac electrograms, Surface ECG
Pubmed
Web of science
Create date
20/12/2019 12:26
Last modification date
20/01/2021 7:26
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