2381/41403
Tiago P. Almeida
Tiago P.
Almeida
GS Chu
GS
Chu
Michael J. Bell
Michael J.
Bell
Xin Li
Xin
Li
JL Salinet
JL
Salinet
N Dastagir
N
Dastagir
JH Tuan
JH
Tuan
PJ Stafford
PJ
Stafford
G André Ng
G
André Ng
Fernando S. Schlindwein
Fernando S.
Schlindwein
The temporal behavior and consistency of bipolar atrial electrograms in human persistent atrial fibrillation
University of Leicester
2018
Atrial fibrillation
Catheter ablation
Electrophysiology mapping
Fractionation
Stability
2018-03-27 13:34:17
Journal contribution
https://figshare.le.ac.uk/articles/journal_contribution/The_temporal_behavior_and_consistency_of_bipolar_atrial_electrograms_in_human_persistent_atrial_fibrillation/10209959
The unstable temporal behavior of atrial electrical activity during persistent atrial fibrillation (persAF) might influence ablation target identification, which could explain the conflicting persAF ablation outcomes in previous studies. We sought to investigate the temporal behavior and consistency of atrial electrogram (AEG) fractionation using different segment lengths. Seven hundred ninety-seven bipolar AEGs were collected with three segment lengths (2.5, 5,and 8 s) from 18 patients undergoing persAF ablation. The AEGs with 8-s duration were divided into three 2.5-s consecutive segments. AEG fractionation classification was applied off-line to all cases following the CARTO criteria; 43% of the AEGs remained fractionated for the three consecutive AEG segments, while nearly 30% were temporally unstable. AEG classification within the consecutive segments had moderate correlation (segment 1 vs 2: Spearman's correlation ρ = 0.74, kappa score κ = 0.62; segment 1 vs 3: ρ = 0.726, κ = 0.62; segment 2 vs 3: ρ = 0.75, κ = 0.68). AEG classifications were more similar between AEGs with 5 and 8 s (ρ = 0.96, κ = 0.87) than 2.5 versus 5 s (ρ = 0.93, κ = 0.84) and 2.5 versus 8 s (ρ = 0.90, κ = 0.78). Our results show that the CARTO criteria should be revisited and consider recording duration longer than 2.5 s for consistent ablation target identification in persAF.