Drs. Gricia and Dulio are employees of Biosense-Webster Inc.
Diagnostic Accuracy of a New Software for Complex Fractionated Electrograms Identification in Patients with Persistent and Permanent Atrial Fibrillation
Version of Record online: 28 JUN 2008
© 2008 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 19, Issue 10, pages 1024–1030, October 2008
How to Cite
CALÒ, L., DE RUVO, E., SCIARRA, L., GRICIA, R., NAVONE, G., DE LUCA, L., NUCCIO, F., SETTE, A., PRISTIPINO, C., DULIO, A., GAITA, F. and LIOY, E. (2008), Diagnostic Accuracy of a New Software for Complex Fractionated Electrograms Identification in Patients with Persistent and Permanent Atrial Fibrillation. Journal of Cardiovascular Electrophysiology, 19: 1024–1030. doi: 10.1111/j.1540-8167.2008.01219.x
Manuscript received 20 January 2008; Revised manuscript received 24 February 2008; Accepted for publication 14 March 2008.
- Issue online: 20 SEP 2008
- Version of Record online: 28 JUN 2008
- atrial fibrillation;
- catheter ablation;
- complex fractionated atrial electrograms
Introduction: The elimination of complex fractionated atrial electrograms (CFAEs) has been proposed as a potential target for guiding successful AF substrate ablation. The possibility to efficiently map the atria and rapidly identify CFAEs sites is necessary, before the CFAEs ablation becomes a routine approach. The aims of this study, conducted in patients with persistent and permanent atrial fibrillation (AF), were to analyze by CARTO mapping in the right (RA) and in the left atrium (LA) during AF: (1) the diagnostic accuracy of a new software for CFAEs analysis, (2) the spatial distribution of CFAEs, (3) the regional beat to beat AF intervals (FF).
Methods and Results: Twenty-five consecutive patients (four women, 58.8 ± 11.4 years) undergoing radiofrequency catheter ablation for persistent and permanent AF were enrolled in the study. The CFAE software showed a high sensitivity (90%) and specificity (91%) in the identification of CFAEs, using a specific setting of parameters. The LA had a significantly higher prevalence of CFAEs as compared with the RA (30.5% vs 20.3%, P = 0.016). The CFAEs were mostly present in the septum and in the area of coronary sinus ostium (CS os). The FF intervals were significantly shorter in the LA than in the RA (P < 0.01).
Conclusion: CARTO system has a high diagnostic accuracy in the identification of CFAEs. Atrial electrical activity (CFAEs, mean FF intervals) during AF showed a significant spatial inhomogeneity.