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Prevalence, characteristics, mapping, and catheter ablation of potential rotors in nonparoxysmal atrial fibrillation
- Source :
- Circulation. Arrhythmia and electrophysiology. 6(5)
- Publication Year :
- 2013
-
Abstract
- Background— Identification of critical atrial substrates in patients with nonparoxysmal atrial fibrillation (AF) failing to respond to pulmonary vein isolation is important. This study investigated the signal characteristics, substrate nature, and ablation results of rotors during AF. Methods and Results— In total, 53 patients (age=55±8), 31 with persistent AF and 22 with long-lasting AF, underwent pulmonary vein isolation and substrate modification of complex fractionated atrial electrograms. Small-radius-reentrant rotors were identified from signal analyses of the dominant frequency and fractionation interval and nonlinear analyses (newly developed, beat-to-beat nonlinear measurement of the repetitiveness of the electrogram morphology >6 seconds). In 15% of the patients, activation maps demonstrated occurrences of rotor-like small-radius reentrant circuits (n=9; 1.1 per patient; cycle length=110±21 ms; diameter=11±6 mm) with fibrillation occurring outside these areas. Rotors were identified by conventional point-by-point mapping and signal analyses and were subsequently eradicated by catheter ablation in these patients. Persistent AF for P P Conclusions— Rotor-like re-entry with fibrillatory conduction was found in a limited number of patients with nonparoxysmal AF after pulmonary vein isolation. Those areas were characterized by rapid repetitive activity with a high degree of electrogram similarity.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Catheter ablation
Pulmonary vein
Electrocardiography
Left atrial
Heart Conduction System
Physiology (medical)
Internal medicine
Atrial Fibrillation
medicine
Prevalence
Humans
Atrium (heart)
Aged
Fibrillation
medicine.diagnostic_test
business.industry
Atrial fibrillation
Middle Aged
Ablation
medicine.disease
medicine.anatomical_structure
Pulmonary Veins
Cardiology
Catheter Ablation
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Electrophysiologic Techniques, Cardiac
Subjects
Details
- ISSN :
- 19413084
- Volume :
- 6
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Circulation. Arrhythmia and electrophysiology
- Accession number :
- edsair.doi.dedup.....957dd4213393ccbb83716d2775d1ba5b