Radiofrequency ablation of complex fractionated atrial electrograms (CFAE): Preferential sites of acute termination and regularization in paroxysmal and persistent atrial fibrillation
Radiofrequency ablation of complex fractionated atrial electrograms (CFAE): Preferential sites of acute termination and regularization in paroxysmal and persistent atrial fibrillation
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DOI：
10.1111/j.1540-8167.2007.00930.x
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发表时间：
2007-10-01
影响因子：
2.7
通讯作者：
Deisenhofer, Isabel
中科院分区：
文献类型：
--
作者：
Schmitt, Claus;Estner, Heidi;Deisenhofer, Isabel
简介：复杂分割心房电图（CFAE）已被描述为消融心房颤动（AF）的新目标。这项前瞻性研究评估了 CFAE 消融对阵发性或持续性 AF 患者的急性影响，并分析了这些影响发生的优先解剖部位。 方法和结果：对 66 名有症状的阵发性 (n = 36) 或持续性 AF (n = 30) 患者（平均年龄 58 +/- 12 岁）进行了 CFAE 消融。 66 名患者中有 56 名 (84%) 在 CFAE 消融期间终止或规范了房颤，66 名患者中有 28 名 (42%) 终止了房颤，66 名患者中有 28 名 (42%) 实现了房颤规范化。 CFAE 消融对 66 名患者中的 10 名（16%）没有效果。 53 个部位发生 AF 终止，81 个部位发生 AF 正规化。房颤终止或正常化的优先部位位于肺静脉周围（终止 n = 15；正常化 n = 22）、前壁（终止 n = 14；正常化 n = 19）和房间隔（终止 n = 8；正常化 n = 17）。结论：通过 CFAE 消融，84% 的患者迅速终止或正常化 AF。房颤终止或调节的优先部位位于肺静脉周围、左心房前壁和房间隔处。这些发现可能对未来的消融概念产生影响。
Introduction: Complex fractionated atrial electrograms (CFAE) have been described as a new target for ablation of atrial fibrillation (AF). This prospective study evaluates the acute effects of CFAE ablation in patients with paroxysmal or persistent AF and analyzes the preferential anatomic sites where these effects occur.Methods and Results: Ablation of CFAE was performed in 66 symptomatic patients (mean age of 58 +/- 12 years) with paroxysmal (n = 36) or persistent AF (n = 30). Termination or regularization of AF during ablation of CFAE was achieved in 56 of 66 patients (84%), with termination in 28 of 66 patients (42%) and regularization of AF in 28 of 66 patients (42%). Ablation of CFAE showed no effect in 10 of 66 patients (16%). Termination of AF occurred at 53 sites and AF regularization at 81 sites. The preferential sites of AF termination or regularization were found around the pulmonary veins (termination n = 15; regularization n = 22), at the anterior wall (termination n = 14; regularization n = 19) and at the interatrial septum (termination n = 8; regularization n = 17).Conclusion: Termination or regularization of AF was achieved acutely in 84% of patients by ablation of CFAE. The preferential sites of AF termination or regularization were found around the pulmonary veins, at the anterior wall of the LA and at the interatrial septum. These findings may have implications for future ablation concepts.