Functional substrate analysis in patients with persistent atrial fibrillation.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-11-01 Epub Date: 2024-05-29 DOI:10.1007/s10840-024-01819-6

Pietro Rossi, Michele Magnocavallo, Filippo Maria Cauti, Marco Polselli, Marta Niscola, Domenico Giovanni Della Rocca, Ambra Del Greco, Luigi Iaia, Raffaele Quaglione, Piccirillo Gianfranco, Stefano Bianchi

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引用次数: 0

Abstract

Objectives: The aim of this study was to describe the correlation between atrial electrogram duration map (AEDUM), spatiotemporal electrogram dispersion (STED) and low voltage areas (LVA) in patients with persistent atrial fibrillation (PsAF).

Background: The degree of left atrial (LA) tissue remodelling and augmented anisotropic conduction is one of the major issues related to PsAF ablation outcome.

Methods: This study enrolled consecutive patients with PsAF undergoing pulmonary vein isolation. In all patients, voltage, AEDUM and STED maps were created, and the correlation was reported between these three mapping methods.

Results: A total of 40 patients with PsAF were enrolled. The mean age was 62.2 ± 7.4 years, and males were 72.5% (n = 29). The overall bipolar voltage of the LA was 3.06 ± 1.87 mV. All patients had at least one AEDUM area (overall AEDUM area: 21.8 ± 8.2 cm²); the mean longest electrogram (EGMs) duration was 90 ± 19 ms. STED areas with < 120 ms was 46.3 ± 20.2 cm² which covered 45 ± 22% of the LA surface. AEDUM and STED areas were most frequently reported on the roof, the anterior wall and the septum. The extension of the AEDUM areas was significantly smaller than STED areas with CL < 120 ms (21.8 ± 8.2 vs 46.3 ± 20.2; p-value < 0.0001). In 24 patients (60%), AEDUM areas was entirely included in the STED areas with CL < 120 ms. In the three (7.5%) patients with LVA, no correspondence with STED and AEDUM was noted.

Conclusion: AEDUM and STED maps allow to identify areas of conductive dysfunction as a possible atrial substrate even if a normal voltage is detected.

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持续性心房颤动患者的功能基质分析。

研究目的本研究旨在描述持续性心房颤动（PsAF）患者的心房电图时程图（AEDUM）、时空电图弥散（STED）和低电压区（LVA）之间的相关性：背景：左心房（LA）组织重塑和各向异性传导增强的程度是与 PsAF 消融结果相关的主要问题之一：本研究连续收治了接受肺静脉隔绝术的 PsAF 患者。所有患者均绘制了电压图、AEDUM 图和 STED 图，并报告了这三种绘图方法之间的相关性：共有 40 名 PsAF 患者入选。平均年龄为 62.2 ± 7.4 岁，男性占 72.5%（n = 29）。LA 的总体双极电压为 3.06 ± 1.87 mV。所有患者至少有一个AEDUM区域（总体AEDUM区域：21.8 ± 8.2平方厘米）；平均最长电图（EGMs）持续时间为90 ± 19毫秒。STED区域有2个，覆盖LA表面的45±22%。AEDUM和STED区域最常出现在屋顶、前壁和室间隔。结论：即使检测到正常电压，AEDUM 和 STED 地图也能将传导功能障碍区域识别为可能的心房基底。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.