Impact of pre-existent areas of complex fractionated atrial electrograms on outcome after pulmonary vein isolation

Giovanni B. Forleo, Massimo Mantica, Lucia De Luca, Antonio Dello Russo, Michela Casella, Luca Santini, Gemma Pelargonio, Francesco Romeo, Claudio Tondo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Atrial fibrillation (AF) drivers outside pulmonary veins (PV) may account for failure after PV isolation. The aim of this study was to characterize pre-existent areas of complex fractionated atrial electrograms (CFAEs) recorded in right atrium (RA) and in coronary sinus (CS) during catheter-based PV isolation and to assess their relation to outcome. Methods and results: With a tricuspid annulus and CS mapping, CFAEs were retrospectively identified in consecutive patients who underwent PV isolation. Of 224 patients, 161 were found to have CFAEs (81%). No clinical variable was found to be predictive of CFAEs presence. By Kaplan-Meier analysis, following a median follow-up of 23.7 months after a single ablation procedure, 62.8% of patients in the CFAEs(+) group and 85.4% of those in the CFAEs(-) group were free from recurrent atrial tachyarrhythmias (p=0.013). Multivariable Cox regression analysis showed that CFAEs evidence was an independent predictor of recurrence (p=0.007). Conclusions: Pre-existent CFAEs, that can be easily identified in RA and CS during PV isolation, are a powerful independent predictor for AF recurrence. This finding may be helpful for refining AF ablation strategies.

Original languageEnglish
Pages (from-to)227-234
Number of pages8
JournalJournal of Interventional Cardiac Electrophysiology
Volume21
Issue number3
DOIs
Publication statusPublished - Apr 2008

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Fractionated electrograms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Impact of pre-existent areas of complex fractionated atrial electrograms on outcome after pulmonary vein isolation'. Together they form a unique fingerprint.

Cite this