Received 15 April 2007; Revised manuscript received 16 May 2007; Accepted for publication 11 June 2007
Radiofrequency Ablation of Complex Fractionated Atrial Electrograms (CFAE): Preferential Sites of Acute Termination and Regularization in Paroxysmal and Persistent Atrial Fibrillation
Article first published online: 16 AUG 2007
Journal of Cardiovascular Electrophysiology
Volume 18, Issue 10, pages 1039–1046, October 2007
How to Cite
SCHMITT, C., ESTNER, H., HECHER, B., LUIK, A., KOLB, C., KARCH, M., NDREPEPA, G., ZRENNER, B., HESSLING, G. and DEISENHOFER, I. (2007), Radiofrequency Ablation of Complex Fractionated Atrial Electrograms (CFAE): Preferential Sites of Acute Termination and Regularization in Paroxysmal and Persistent Atrial Fibrillation. Journal of Cardiovascular Electrophysiology, 18: 1039–1046. doi: 10.1111/j.1540-8167.2007.00930.x
- Issue published online: 16 AUG 2007
- Article first published online: 16 AUG 2007
- atrial fibrillation;
- complex fractionated electrograms;
- catheter ablation;
- acute effects;
Introduction: Complex fractionated atrial electrograms (CFAE) have been described as a new target for ablation of atrial fibrillation (AF). This prospective study evaluates the acute effects of CFAE ablation in patients with paroxysmal or persistent AF and analyzes the preferential anatomic sites where these effects occur.
Methods and Results: Ablation of CFAE was performed in 66 symptomatic patients (mean age of 58 ± 12 years) with paroxysmal (n = 36) or persistent AF (n = 30). Termination or regularization of AF during ablation of CFAE was achieved in 56 of 66 patients (84%), with termination in 28 of 66 patients (42%) and regularization of AF in 28 of 66 patients (42%). Ablation of CFAE showed no effect in 10 of 66 patients (16%). Termination of AF occurred at 53 sites and AF regularization at 81 sites. The preferential sites of AF termination or regularization were found around the pulmonary veins (termination n = 15; regularization n = 22), at the anterior wall (termination n = 14; regularization n = 19) and at the interatrial septum (termination n = 8; regularization n = 17).
Conclusion: Termination or regularization of AF was achieved acutely in 84% of patients by ablation of CFAE. The preferential sites of AF termination or regularization were found around the pulmonary veins, at the anterior wall of the LA and at the interatrial septum. These findings may have implications for future ablation concepts.