Seiichiro Matsuo1, Teiichi Yamane, Taro Date, Ken-Ichi Tokutake, Mika Hioki, Keiichi Ito, Ryohsuke Narui, Shin-Ichi Tanigawa, Michifumi Tokuda, Seigo Yamashita, Keiichi Inada, Kosuke Minai, Kimiaki Komukai, Ken-Ichi Sugimoto, Michihiro Yoshimura.
Abstract
BACKGROUND: Paroxysmal atrial fibrillation (PAF) can be treated with pulmonary vein isolation (PVI). A spectral analysis can identify sites of high-frequency activity during atrial fibrillation (AF). We investigated the role of the PVs on AF perpetuation by dominant frequency (DF) analysis.
METHODS: Thirty-one consecutive patients with PAF who underwent PVI were included in the prospective study. DF was calculated in each of the PVs, 16, five, and five sites in the left atrium, the coronary sinus, and the right atrium, respectively. In patients presenting sinus rhythm at the baseline, AF was induced by pacing. The PVs were then divided into two groups; PVs demonstrated the highest DF (HDF-PV) and others.
RESULTS: One patient was excluded from the analysis because sustained AF could not be induced. AF was terminated in 43.3% (13/30) of patients during ablation. Of 92 PVs isolated during AF, 30 and 62 PVs were classified into the HDF-PV and others, respectively. PAF was more frequently terminated by the HDF-PV isolation compared to the others (33.3% [10/30] vs 4.8% [3/62], P = 0.0004). Interestingly, nine of the 30 HDF-PVs showing the highest DF among all 30 regions, including extra PVs, led to AF termination in 88.9% (eight out of nine) of cases. Moreover, the HDF-PVs isolation resulted in a greater AF cycle length prolongation than the other PVs isolation (12.1±5.0 vs 2.7±7.6 ms, P = 0.007).
CONCLUSION: Termination of PAF was more frequently observed during ablation of the PVs with the highest DF. The PV showing high DF played an important role in the maintenance of PAF. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
BACKGROUND: Paroxysmal atrial fibrillation (PAF) can be treated with pulmonary vein isolation (PVI). A spectral analysis can identify sites of high-frequency activity during atrial fibrillation (AF). We investigated the role of the PVs on AF perpetuation by dominant frequency (DF) analysis.
METHODS: Thirty-one consecutive patients with PAF who underwent PVI were included in the prospective study. DF was calculated in each of the PVs, 16, five, and five sites in the left atrium, the coronary sinus, and the right atrium, respectively. In patients presenting sinus rhythm at the baseline, AF was induced by pacing. The PVs were then divided into two groups; PVs demonstrated the highest DF (HDF-PV) and others.
RESULTS: One patient was excluded from the analysis because sustained AF could not be induced. AF was terminated in 43.3% (13/30) of patients during ablation. Of 92 PVs isolated during AF, 30 and 62 PVs were classified into the HDF-PV and others, respectively. PAF was more frequently terminated by the HDF-PV isolation compared to the others (33.3% [10/30] vs 4.8% [3/62], P = 0.0004). Interestingly, nine of the 30 HDF-PVs showing the highest DF among all 30 regions, including extra PVs, led to AF termination in 88.9% (eight out of nine) of cases. Moreover, the HDF-PVs isolation resulted in a greater AF cycle length prolongation than the other PVs isolation (12.1±5.0 vs 2.7±7.6 ms, P = 0.007).
CONCLUSION: Termination of PAF was more frequently observed during ablation of the PVs with the highest DF. The PV showing high DF played an important role in the maintenance of PAF. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
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Mesh：
Year: 2011
PMID： 22054201 DOI： 10.1111/j.1540-8159.2011.03259.x
Source DB: PubMed Journal: Pacing Clin Electrophysiol ISSN： 0147-8389 Impact factor: 1.976