Electrophysiologic characteristics of complex fractionated atrial electrograms in patients with atrial fibrillation.

INTRODUCTION: The underlying mechanisms of complex fractionated atrial electrogram (CFAE) during radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) have not yet been clearly elucidated. We explored the relationships between CFAE and left atrial (LA) voltage, or conduction velocity (CV).

METHODS AND RESULTS: In 50 patients with AF (23 paroxysmal AF [PAF], 41 males, mean age 55.76 +/- 10.16 years), the CFAE (average index of fractionation of electrograms during AF by interval-analysis algorithm, cycle length [CL]
CONCLUSIONS: The CFAE area, which is primarily located at the septum, has a low voltage with a lower CV, and is surrounded by high-voltage areas. Underlying electroanatomical complexity is associated with clustering of CFAEs.