Functional Nature of Electrogram Fractionation Demonstrated by Left Atrial High Density Mapping

摘要: Background— Complex fractionated atrial electrograms (CFAE) are targets of fibrillation (AF) ablation. Serial high-density maps were evaluated to understand the impact activation direction and rate on electrogram (EGM) fractionation. Methods Results— Eighteen patients (9 persistent) underwent high-density, 3-dimensional, left-atrial mapping (>400 points/map) during AF, sinus (SR), CS-paced (CSp) rhythms. In SR CSp, fractionation was defined as an EGM with ≥4 deflections, although, in CFE-mean 1.0 mV) at all sites. During voltage higher continuous CFAE sites than non-CFAE (0.53 mV (Q1, Q3: 0.33 0.83) versus 0.30 0.18 0.515), P <0.00001). Global LA AF lower persistent paroxysmal (0.6+/−0.59 1.12+/−1.32 mV, <0.01). Conclusions— The distribution EGMs is highly variable, depending (SR CSp AF). Fractionation rhythms mostly resulted from wave collision. All displayed normal SR, suggesting absence structural scar. Thus, many functional nature, their dynamic.