Inverse Relationship Between Fractionated Electrograms and Atrial Fibrosis in Persistent Atrial Fibrillation Combined Magnetic Resonance Imaging and High-Density Mapping
Inverse Relationship Between Fractionated Electrograms and Atrial Fibrosis in Persistent Atrial Fibrillation Combined Magnetic Resonance Imaging and High-Density Mapping
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DOI：
10.1016/j.jacc.2013.03.081
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发表时间：
2013-08-27
影响因子：
24
通讯作者：
Jais, Pierre
中科院分区：
文献类型：
--
作者：
Jadidi, Amir S.;Cochet, Hubert;Jais, Pierre
目的探讨持续性心房颤动（AF）患者的延迟增强磁共振成像（DE）显示的纤维化与心房电图（Egms）的关系。方法对18例持续性房颤患者（11例持续性房颤）行心房高分辨率MRI检查，采用NavX电解剖系统（8.0版，St. Jude Medical，圣保罗，Minnesota）进行标测。DE区域根据其DE含量分为密集或斑块。使用高密度20极导管（514 +/- 77个部位/标测图）采集AF期间的左心房电图。分析DE的分级、组织/规律性、局部平均周期长度（CL）和电压。结果长期持续性AF患者与持续性AF患者相比，左心房（LA）表面积较大（134 +/- 38 cm（2）vs. 98 +/- 9 cm（2），p = 0.02），心房DE量较高（70 +/- 16 cm（2）vs. 49 +/- 10 cm（2），p = 0.01），更复杂的碎裂心房Egm（CFAE）范围（54 +/- 16 cm（2）vs. 28 +/- 15 cm（2），p 0.02）和较短的基线AF CL（147 +/- 10 ms vs. 182 +/- 14 ms，p 0.01）。连续CFAE（CFEmean [量化Egm分级的NavX算法]
Objectives This study sought to evaluate the relationship between fibrosis imaged by delayed-enhancement (DE) magnetic resonance imaging (MRI) and atrial electrograms (Egms) in persistent atrial fibrillation (AF).Background Atrial fractionated Egms are strongly related to slow anisotropic conduction. Their relationship to atrial fibrosis has not yet been investigated.Methods Atrial high-resolution MRI of 18 patients with persistent AF (11 long-lasting persistent AF) was registered with mapping geometry (NavX electro-anatomical system (version 8.0, St. Jude Medical, St. Paul, Minnesota)). DE areas were categorized as dense or patchy, depending on their DE content. Left atrial Egms during AF were acquired using a high-density, 20-pole catheter (514 +/- 77 sites/map). Fractionation, organization/regularity, local mean cycle length (CL), and voltage were analyzed with regard to DE.Results Patients with long-lasting persistent versus persistent AF had larger left atrial (LA) surface area (134 +/- 38 cm(2) vs. 98 +/- 9 cm(2), p = 0.02), a higher amount of atrial DE (70 +/- 16 cm(2) vs. 49 +/- 10 cm(2), p = 0.01), more complex fractionated atrial Egm (CFAE) extent (54 +/- 16 cm(2) vs. 28 +/- 15 cm(2), p 0.02), and a shorter baseline AF CL (147 +/- 10 ms vs. 182 +/- 14 ms, p 0.01). Continuous CFAE (CFEmean [NavX algorithm that quantifies Egm fractionation]