Spatiotemporal Behavior of High Dominant Frequency During Paroxysmal and Persistent Atrial Fibrillation in the Human Left Atrium
- 1 August 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation: Arrhythmia and Electrophysiology
- Vol. 5 (4), 650-658
- https://doi.org/10.1161/circep.111.967992
Abstract
Background—: Sites of high dominant frequency (DF peak ) are thought to indicate the location of drivers of atrial fibrillation (AF), but characterization of their spatiotemporal distribution and stability, critical to their relevance as targets for catheter ablation, requires simultaneous global mapping of the left atrium. Methods and Results—: Noncontact electrograms recorded simultaneously from 256 left atrial sites during spontaneous AF were analyzed. After subtraction of the ventricular component, fast Fourier transform identified the DF at each site. Focal areas of DF peak were defined as those having a DF >20% above all neighboring sites. Twenty-four patients with spontaneous AF (11 paroxysmal and 13 persistent) were studied. In paroxysmal AF, sites of DF peak (mean DF, 11.6±2.9 Hz) were observed in 100% of patients (present during 65% of the mapping period). In contrast, DF peak was detected in only 31% of patients with persistent AF ( P P peak varied widely in both consecutive and separated segments of AF (κ coefficient range, -0.07–0.22). Activation sequences around sites of DF peak did not demonstrate centrifugal activation that would be expected from focal drivers. Conclusions—: Focal areas of high DF are more frequent in paroxysmal than persistent AF, are spatiotemporally unstable, are not the source of centrifugal activation, and are not, therefore, indicative of fixed drivers of AF. In the absence of spatiotemporal stability, the success of ablation at sites of DF peak cannot be explained by elimination of fixed drivers.Keywords
This publication has 27 references indexed in Scilit:
- Dominant Frequency Mapping of Atrial Fibrillation: Comparison of Contact and Noncontact ApproachesJournal of Cardiovascular Electrophysiology, 2009
- Real-time dominant frequency mapping and ablation of dominant frequency sites in atrial fibrillation with left-to-right frequency gradients predicts long-term maintenance of sinus rhythmHeart Rhythm, 2009
- Atrial Fibrillation Begets Atrial Fibrillation in the Pulmonary Veins: On the Impact of Atrial Fibrillation on the Electrophysiological Properties of the Pulmonary Veins in HumansJournal of the American College of Cardiology, 2008
- Characterization of Electrograms Associated With Termination of Chronic Atrial Fibrillation by Catheter AblationJournal of the American College of Cardiology, 2008
- Quantifying fractionation and rate in human atrial fibrillation using monophasic action potentials: implications for substrate mappingEP Europace, 2007
- Validation of the Frequency Spectra Obtained from the Noncontact Unipolar Electrograms During Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2007
- Validation of the Noncontact Mapping System in the Left Atrium During Permanent Atrial Fibrillation and Sinus RhythmJournal of the American College of Cardiology, 2006
- Spectral Analysis Identifies Sites of High-Frequency Activity Maintaining Atrial Fibrillation in HumansCirculation, 2005
- Epicardial Mapping of Chronic Atrial Fibrillation in PatientsCirculation, 2004
- Atrial fibrillation as a self-sustaining arrhythmia independent of focal dischargeAmerican Heart Journal, 1959