Paroxysmal atrial fibrillation maintained by nonpulmonary vein sources can be predicted by dominant frequency analysis of atriopulmonary electrograms

Eriko Yokoyama, Toshiyuki Osaka, Yoshio Takemoto, Tomoyuki Suzuki, Atsushi Ito, Kaichiro Kamiya, Itsuo Kodama
Journal of Cardiovascular Electrophysiology 2009, 20 (6): 630-6

INTRODUCTION: Increasing evidence suggests that high-frequency excitation in the pulmonary vein (PV) plays a dominant role in the maintenance of paroxysmal atrial fibrillation (AF). However, in a certain population of patients, AF remains inducible after PV isolation (PVI). We sought to clarify whether dominant frequency (DF) analysis of atriopulmonary electrograms can predict paroxysmal AF maintained by non-PV sources.

METHODS AND RESULTS: Sixty-one patients with paroxysmal AF (aged 59 +/- 12 years) were studied. Before PVI, bipolar electrograms during AF were recorded simultaneously from three PV ostia, the coronary sinus (CS), and the septum and free wall of the right atrium (RA). DF was obtained by fast Fourier transform (FFT) analysis. AF was rendered noninducible after PVI in 39 of the 61 patients (noninducible group), but was still inducible in the remaining 22 (inducible group). Among the six recording sites, the highest DF was documented in the PV in all of the patients in the noninducible group; the maximum DF among the three PVs (PV-DF(max)) was higher than that among the CS and two RA sites (atrial DF(max); 7.2 +/- 1.0 Hz vs 5.8 +/- 0.7 Hz, P < 0.0001). In contrast, the highest DF was documented in the CS or RA in 45.5% of the patients in the inducible group; PV-DF(max) was comparable with atrial DF(max) (6.6 +/- 0.8 Hz vs 6.6 +/- 0.6 Hz). AF inducibility after PVI was predicted by a PV-to-atrial DF(max) gradient of <0.5 Hz, with a sensitivity of 90.9% and a specificity of 89.7%.

CONCLUSION: Paroxysmal AF maintained by non-PV sources can be predicted by the PV-to-atrial DF gradient.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"