Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis
Introduction: Rotors and complex fractionated atrial electrograms (CFAEs) have been suggested as possible therapeutic targets in ablation of atrial fibrillation (AF). The aim of this study was to assess the relationship between rotors and CFAEs in patients with AF. Methods: We studied 18 patients wi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2017-04-01
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| Series: | Revista Portuguesa de Cardiologia |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0870255117301579 |
| _version_ | 1818283681043709952 |
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| author | Pedro Adragão Pedro Carmo Diogo Cavaco João Carmo António Ferreira Francisco Moscoso Costa Maria Salomé Carvalho João Mesquita Rita Quaresma Francisco Belo Morgado Miguel Mendes |
| author_facet | Pedro Adragão Pedro Carmo Diogo Cavaco João Carmo António Ferreira Francisco Moscoso Costa Maria Salomé Carvalho João Mesquita Rita Quaresma Francisco Belo Morgado Miguel Mendes |
| author_sort | Pedro Adragão |
| collection | DOAJ |
| description | Introduction: Rotors and complex fractionated atrial electrograms (CFAEs) have been suggested as possible therapeutic targets in ablation of atrial fibrillation (AF). The aim of this study was to assess the relationship between rotors and CFAEs in patients with AF. Methods: We studied 18 patients with AF (mean age 69±8 years, 33% female) who underwent rotor ablation and pulmonary vein isolation. Endocardial mapping was performed with a basket catheter to identify the presence, number and location of rotors and CFAEs. The FIRM™ (Abbott) and CARTO™ (Biosense) systems were used with overlapping of frames from continuous 30-s recordings. CFAEs were classified as stable if present in >15 frames, moderately stable if present in 10-15 frames and unstable if present in 5-9 frames. Results: A total of 44 rotors and 60 CFAEs (39 of them stable) were identified. The mean number of rotors and stable CFAEs per patient was 2.6±1.4 and 2.2±1.5, respectively. In 27 of the 44 identified rotors, CFAEs were found in the same location. Conversely, in 20 of the 39 stable CFAEs identified, a focal rotor was found in the same location. The majority of CFAEs found at the same location as a focal rotor were stable (63% vs. 37%, p=0.001). Conclusion: Rotors and CFAEs are frequently found in the same location within the atria, particularly when only stable CFAEs are considered. This relationship may have implications in the selection of substrate targets for ablation. Resumo: Introdução: Os rotores e potenciais complexos fracionados (CFAE) têm sido apontados como possíveis alvos terapêuticos na ablação de fibrilhação auricular (FA). O objetivo deste estudo foi avaliar a relação entre CFAE e rotores em doentes com FA. Métodos: Foram estudados 18 doentes com FA (idade média 69 ± 8, 33% mulheres) submetidos a ablação de rotores e isolamento das veias pulmonares. Efetuou-se mapeamento endocárdico com cateter basket para identificação da presença, número e localização de rotores e CFAEs. Foram utilizados os sistemas FIRM (Abbott) e CARTO (Biosense) com sobreposição de frames obtidos a partir de registos contínuos de 30 segundos. Os CFAEs foram classificados em estáveis se presentes em > 15 frames, moderadamente estáveis se presentes em 10-15 frames e pouco estáveis se presentes em 5-9 frames. Resultados: Foram identificados 44 rotores e 60 CFAEs, dos quais 39 eram CFAE estáveis. O número médio de rotores e CFAE estáveis por doente foi de 2,6 ± 1,4 e 2,2 ± 1,5, respetivamente. Em 27 dos 44 rotores identificados, encontraram-se CFAEs na mesma localização. Por outro lado, em 20 dos 39 CFAE estáveis identificados, foi encontrado um rotor na mesma localização. A maioria dos CFAEs encontrados na mesma localização dos rotores eram CFAE estáveis (63% versus 37%, p = 0.001). Conclusões: Os rotors e CFAEs são frequentemente encontrados na mesma localização a nível auricular, especialmente se apenas se considerarem os CFAEs estáveis. Esta relação poderá vir a ter implicações na seleção do substrato arritmogénico passível de ablação. Keywords: Atrial fibrillation, Catheter ablation, Rotors, Complex fractionated atrial electrograms, Stable complex fractionated atrial electrograms, Palavras-chave: Fibrilhação auricular, Ablação por cateter, Rotores, Eletrogramas potenciais complexos fraccionados, Eletrogramas potenciais complexos fraccionados estáveis |
| first_indexed | 2024-12-13T00:40:46Z |
| format | Article |
| id | doaj.art-0120380546c742e4ac54fbc934d5acf9 |
| institution | Directory Open Access Journal |
| issn | 0870-2551 |
| language | English |
| last_indexed | 2024-12-13T00:40:46Z |
| publishDate | 2017-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Revista Portuguesa de Cardiologia |
| spelling | doaj.art-0120380546c742e4ac54fbc934d5acf92022-12-22T00:05:07ZengElsevierRevista Portuguesa de Cardiologia0870-25512017-04-01364233238Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysisPedro Adragão0Pedro Carmo1Diogo Cavaco2João Carmo3António Ferreira4Francisco Moscoso Costa5Maria Salomé Carvalho6João Mesquita7Rita Quaresma8Francisco Belo Morgado9Miguel Mendes10Corresponding author.; Department of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalDepartment of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, PortugalIntroduction: Rotors and complex fractionated atrial electrograms (CFAEs) have been suggested as possible therapeutic targets in ablation of atrial fibrillation (AF). The aim of this study was to assess the relationship between rotors and CFAEs in patients with AF. Methods: We studied 18 patients with AF (mean age 69±8 years, 33% female) who underwent rotor ablation and pulmonary vein isolation. Endocardial mapping was performed with a basket catheter to identify the presence, number and location of rotors and CFAEs. The FIRM™ (Abbott) and CARTO™ (Biosense) systems were used with overlapping of frames from continuous 30-s recordings. CFAEs were classified as stable if present in >15 frames, moderately stable if present in 10-15 frames and unstable if present in 5-9 frames. Results: A total of 44 rotors and 60 CFAEs (39 of them stable) were identified. The mean number of rotors and stable CFAEs per patient was 2.6±1.4 and 2.2±1.5, respectively. In 27 of the 44 identified rotors, CFAEs were found in the same location. Conversely, in 20 of the 39 stable CFAEs identified, a focal rotor was found in the same location. The majority of CFAEs found at the same location as a focal rotor were stable (63% vs. 37%, p=0.001). Conclusion: Rotors and CFAEs are frequently found in the same location within the atria, particularly when only stable CFAEs are considered. This relationship may have implications in the selection of substrate targets for ablation. Resumo: Introdução: Os rotores e potenciais complexos fracionados (CFAE) têm sido apontados como possíveis alvos terapêuticos na ablação de fibrilhação auricular (FA). O objetivo deste estudo foi avaliar a relação entre CFAE e rotores em doentes com FA. Métodos: Foram estudados 18 doentes com FA (idade média 69 ± 8, 33% mulheres) submetidos a ablação de rotores e isolamento das veias pulmonares. Efetuou-se mapeamento endocárdico com cateter basket para identificação da presença, número e localização de rotores e CFAEs. Foram utilizados os sistemas FIRM (Abbott) e CARTO (Biosense) com sobreposição de frames obtidos a partir de registos contínuos de 30 segundos. Os CFAEs foram classificados em estáveis se presentes em > 15 frames, moderadamente estáveis se presentes em 10-15 frames e pouco estáveis se presentes em 5-9 frames. Resultados: Foram identificados 44 rotores e 60 CFAEs, dos quais 39 eram CFAE estáveis. O número médio de rotores e CFAE estáveis por doente foi de 2,6 ± 1,4 e 2,2 ± 1,5, respetivamente. Em 27 dos 44 rotores identificados, encontraram-se CFAEs na mesma localização. Por outro lado, em 20 dos 39 CFAE estáveis identificados, foi encontrado um rotor na mesma localização. A maioria dos CFAEs encontrados na mesma localização dos rotores eram CFAE estáveis (63% versus 37%, p = 0.001). Conclusões: Os rotors e CFAEs são frequentemente encontrados na mesma localização a nível auricular, especialmente se apenas se considerarem os CFAEs estáveis. Esta relação poderá vir a ter implicações na seleção do substrato arritmogénico passível de ablação. Keywords: Atrial fibrillation, Catheter ablation, Rotors, Complex fractionated atrial electrograms, Stable complex fractionated atrial electrograms, Palavras-chave: Fibrilhação auricular, Ablação por cateter, Rotores, Eletrogramas potenciais complexos fraccionados, Eletrogramas potenciais complexos fraccionados estáveishttp://www.sciencedirect.com/science/article/pii/S0870255117301579 |
| spellingShingle | Pedro Adragão Pedro Carmo Diogo Cavaco João Carmo António Ferreira Francisco Moscoso Costa Maria Salomé Carvalho João Mesquita Rita Quaresma Francisco Belo Morgado Miguel Mendes Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis Revista Portuguesa de Cardiologia |
| title | Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis |
| title_full | Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis |
| title_fullStr | Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis |
| title_full_unstemmed | Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis |
| title_short | Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis |
| title_sort | relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational analysis |
| url | http://www.sciencedirect.com/science/article/pii/S0870255117301579 |
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