Novel assessment of temporal variation in fractionated electrograms using histogram analysis of local fractionation interval in patients with persistent atrial fibrillation

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Title:	Novel assessment of temporal variation in fractionated electrograms using histogram analysis of local fractionation interval in patients with persistent atrial fibrillation
Authors:	林澂;Lin, Yenn-Jiang;Suenari, Kazuyoshi;Lo, Men-Tzung;Lin, Chen;Hsieh, Wan-Hsin;Chang, Shih-Lin;Lo, Li-Wei;Hu, Yu-Feng;Cheng, Chen-Chuan;Kihara, Yasuki;Chao, Tze-Fan;Hartono, Beny;Wu, Tsu-Juey;Lin, Wei-Shiang;Hsu, Ke-Hsin;Kibos, Ambrose S.;Huang, Norden E.;Chen, Shih-Ann
Contributors:	生醫理工學院生醫科學與工程學系
Keywords:	Atrial Fibrillation;Catheter Ablation;Data Interpretation, Statistical;Electrocardiography;Electrophysiologic Techniques, Cardiac;Female;Humans;Male;Middle Aged;Retrospective Studies;Survival Rate;Time Factors;Treatment Outcome
Date:	2012-10-01
Issue Date:	2026-04-23 11:18:07 (UTC+8)
Publisher:	Ovid Technologies (Wolters Kluwer Health)
Abstract:	摘要： Background—The characteristics of atrial electrograms associated with atrial fibrillation (AF) termination are controversial. We investigated the electrogram characteristics that indicate procedural AF termination during continuous complex fractionated electrogram ablation.Methods and Results—Fifty-two consecutive patients with persistent AF (47 men; aged 54±9 years), who underwent electrogram-based catheter ablation in the left atrium and coronary sinus after pulmonary vein isolation, were enrolled. The intracardiac bipolar atrial electrogram recordings were characterized by (1) fractionation interval (FI) analysis (>6 seconds), (2) kurtosis (shape of the FI histogram), and (3) skewness (asymmetry of the FI histogram). Sites showing complex, fractionated electrograms (mean FI ≤60 ms) were targeted, and AF was terminated in 20 patients (38%) after the pulmonary vein isolation. The conventional complex fractionated electrogram sites (mean ≤120 ms) in patients with AF termination exhibited higher median kurtosis (2.69 [interquartile range, 2.03–3.46] versus 2.35 [interquartile range, 1.79–2.48];P=0.024) and higher complex fractionated electrogram-mean interval (102.7±19.8 versus 87.7±15.0;P=0.008) than patients without AF termination. Furthermore, AF termination sites had higher median kurtosis than targeted sites without AF termination (5.13 [interquartile range, 3.51–6.47] versus 4.18 [interquartile range, 2.91–5.34];P<0.01) in patients with procedural termination. In addition, patients with AF termination had a higher sinus rhythm maintenance rate after a single procedure than patients without AF termination (log-rank test,P=0.007).Conclusions—A kurtosis analysis using the FI histogram may be a useful tool in identifying the critical substrate for persistent AF and potential responders to catheter ablation. 出版者： Ovid Technologies (Wolters Kluwer Health) 出版日期： 2012-10 出處： Circulation: Arrhythmia and Electrophysiology, 2012-10, Vol.5 (5), p.949-956 識別號： ISSN: 1941-3149 識別號： DOI: 10.1161/circep.111.967612
Appears in Collections:	[Department of Biomedical Sciences and Engineering ] journal & Dissertation

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