1. Characterization of Atrial Substrate using Close-Coupled Paced Electrogram Feature Analysis (PEFA) in Patients with Non-valvular Atrial Fibrillation.
- Author
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Neira, Victor, Hanson, Matthew, Shariat, M. Hassan, Orellana-Cáceres, Juan-José, Miranda, Andres, Enriquez, Andres, Chacko, Sanoj, Simpson, Christopher, Abdollah, Hoshiar, Baranchuk, Adrian, and Redfearn, Damian P.
- Subjects
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ATRIAL fibrillation , *VENTRICULAR fibrillation , *VENTRICULAR tachycardia , *ATRIAL arrhythmias , *ARRHYTHMIA - Abstract
Mapping strategies that enhance understanding and therapy for atrial fibrillation (AF) remain essential. The paced electrogram feature analysis (PEFA) technique has previously identified slow conduction zones within the ventricle critical for ventricular fibrillation (VF) or ventricular tachycardia. This prospective, exploratory cohort study aimed to determine if PEFA identifies similar slow conduction zones in the left atrium (LA) of patients with AF compared to controls.The study compared patients with paroxysmal AF undergoing catheter ablation with a control group of non-AF patients undergoing left-side electrophysiological procedures. Four electrogram (EGM) characteristics were assessed in the LA at various locations: EGM duration (ms), last deflection (ms), voltage (mV), and latency (ms). Normal values were established from the control cohort and used to calculate the percentage of abnormal EGM features in AF patients. The study included 24 AF patients and 8 controls. AF patients exhibited a higher proportion of abnormal EGM values compared to controls: last deflection 17.2%, latency 16.4%, voltage 8.5%, and EGM duration 9.8%. Normal values determined from the analysis were: 201.5 ms for last deflection, 84.3 ms for EGM duration, 77.7 ms for latency, and 0.26 mV for voltage. This study employed PEFA in the LA to identify previously undescribed metrics of atrial myopathy associated with AF. PEFA represents a potential method for characterizing the AF substrate by targeting abnormal atrial responses to closely coupled stimulation. [ABSTRACT FROM AUTHOR]
- Published
- 2024