Letter by Berenfeld and Jalife regarding article "dominant frequency of atrial fibrillation correlates poorly with atrial fibrillation cycle length".
نویسندگان
چکیده
BACKGROUND Localized sites of high frequency during atrial fibrillation (AF) are used as target sites to eliminate AF. Spectral analysis is used experimentally to determine these sites. The purpose of this study was to compare dominant frequencies (DF) with AF cycle length (AFCL) of unipolar and bipolar recordings. METHODS AND RESULTS Left and right atrial endocardial electrograms were recorded during AF in 40 patients with lone AF, using two 20-polar catheters. Mean age was 53+/-9.9 years. Unipolar and bipolar electrograms were recorded simultaneously during 16 seconds at 2 right and 4 left atrial sites. AFCLs and DFs were determined. QRS subtraction was performed in unipolar signals. DFs were compared with mean, median, and mode of AFCLs; 4800 unipolar and 2400 bipolar electrograms were analyzed. Intraclass correlation was poor for all spectral analysis protocols. Best correlation was accomplished with DFs from unipolar electrograms compared with median AFCL (intraclass correlation coefficient, 0.67). A gradient in median AFCL of >25% was detected in 16 of 40 patients. In 13 of 16 patients (81%) with a frequency gradient of >25%, the site with highest frequency was located in the left atrium (posterior left atrium in 8 patients). The site with shortest median AFCL and highest DF corresponded in 25% if unipolar and in 31% if bipolar electrograms were analyzed. CONCLUSIONS DFs from unipolar and bipolar electrograms recorded during AF correlated poorly with mean, median, and mode AFCL. If a frequency gradient >25% existed, the site with highest DF corresponded to the site of shortest median AFCL in only 25% of patients. Because spectral analysis is being used to identify ablation sites, these data may have important clinical implications.
منابع مشابه
Letter by Platonov et Al regarding article, "Dominant frequency of atrial fibrillation correlates poorly with atrial fibrillation cycle length".
متن کامل
Intra-atrial pressure increases rate and organization of waves emanating from the superior pulmonary veins during atrial fibrillation.
BACKGROUND Atrial fibrillation (AF) commonly associates with atrial dilatation by poorly understood mechanisms. We hypothesized that elevation of intra-atrial pressure elicits high-frequency and spatio-temporally organized left atrial (LA) sources emanating from the superior pulmonary veins. METHODS AND RESULTS We used a stretch-related AF model in the sheep heart to induce stable episodes of...
متن کاملIncreased IL-17A in Atrial Fibrillation Correlates with Neutrophil to Lymphocyte Ratio
Background: Atrial Fibrillation (AF) is the most common cardiac arrhythmia and an independent risk factor for stroke among the elderly. A role for inflammation in the atrial remodeling as well as development and recurrence of AF is known. Objective: To compare IL-17A between patients with different types of AF and healthy individuals. Methods: IL-17A was measured in sera of 112 patients and 107...
متن کاملEffects Of Fast Pathway Ablation On The Concealment Zone And Electrophysiological Behavior Of AV-Node During Atrial Fibrillation.
Objectives: Dual pathways have a determinant role in the occurrence of atrio nodal tachyarrhythmia (AVNRT). The aim of present study is to determine the role of slow pathway (SP) in the concealment zone and protective role of AV node during atrial fibrillation (AF). Material &Methods: In 7 isolated nodal rabbit preparation zone of concealment and concealed conduction is quantified by Specif...
متن کاملSpatiotemporal periodicity during atrial fibrillation in the isolated sheep heart.
BACKGROUND The activation patterns that underlie the irregular electrical activity during atrial fibrillation (AF) have traditionally been described as disorganized or random. Recent studies, based predominantly on statistical methods, have provided evidence that AF is spatially organized. The objective of this study was to demonstrate the presence of spatial and temporal periodicity during AF....
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Circulation. Arrhythmia and electrophysiology
دوره 3 1 شماره
صفحات -
تاریخ انتشار 2009