35. Mapping of Atrial Fibrillation: Comparing Complex Fractionated Atrial Electrograms, Voltage Maps, Dominant Frequency Maps and Ganglionic Plexi

  1. Mohammad Shenasa MD2,
  2. Gerhard Hindricks MD3,
  3. Martin Borggrefe MD4,
  4. Günter Breithardt MD5 and
  5. Mark E. Josephson MD6
  1. Amin Al-Ahmad and
  2. John A. Schoenhard

Published Online: 18 DEC 2012

DOI: 10.1002/9781118481585.ch35

Cardiac Mapping, Fourth Edition

Cardiac Mapping, Fourth Edition

How to Cite

Al-Ahmad, A. and Schoenhard, J. A. (2013) Mapping of Atrial Fibrillation: Comparing Complex Fractionated Atrial Electrograms, Voltage Maps, Dominant Frequency Maps and Ganglionic Plexi, in Cardiac Mapping, Fourth Edition (eds M. Shenasa, G. Hindricks, M. Borggrefe, G. Breithardt and M. E. Josephson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118481585.ch35

Editor Information

  1. 2

    Attending Physician, Department of Cardiovascular Services, O'Connor Hospital, Heart & Rhythm Medical Group, San Jose, California, USA

  2. 3

    Professor of Medicine (Cardiology), University Leipzig, Heart Center, Director, Department of Electrophysiology, Leipzig, Germany

  3. 4

    Professor of Medicine (Cardiology), Head, Department of Cardiology, Angiology and Pneumology, University Medical Center, Mannheim Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

  4. 5

    Professor Emeritus of Medicine and Cardiology, Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany

  5. 6

    Chief, Cardiovascular Medicine Division, Director, Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Herman C. Dana Professor of Medicine, Harvard Medical School, Boston, Massachusetts, USA

Author Information

  1. Stanford University Medical Center, Stanford, CA, USA

Publication History

  1. Published Online: 18 DEC 2012
  2. Published Print: 10 JAN 2013

ISBN Information

Print ISBN: 9780470670460

Online ISBN: 9781118481585

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Keywords:

  • atrial fibrillation;
  • radio-frequency ablation;
  • pulmonary vein isolation;
  • complex fractionated atrial electrogram;
  • voltage map;
  • dominant frequency;
  • autonomic nervous system;
  • ganglionic plexi

Summary

Catheter-based radio-frequency ablation is an effective therapy for controlling atrial fibrillation (AF) in appropriately selected patients. While anatomic pulmonary vein isolation is typically sufficient for individuals with paroxysmal AF, adjunctive substrate modification within the body of the left atrium is often necessary in individuals with persistant AF. Several cardiac mapping strategies can be used to accurately target ablation for improved efficacy and limit unnecessary ablation for improved safety. These include identification of complex fractionated atrial electrograms, measurement of voltage in sinus rhythm and AF, assessment of dominant frequency and localization of ganglionic plexi. This chapter will compare these overlapping methodologies and provide recommendations with regard to their utilization.