Abstract 16789: Activation Sequence within the Pulmonary Vein as the Driving Sources of Atrial Fibrillation: Three-dimensional Analysis Using a Non-contact Mapping System

• Published in: Circulation (New York, N.Y.) N.Y.), 2015-11, Vol.132 (Suppl_3 Suppl 3), p.A16789-A16789
• Main Authors: Yamabe, Hiroshige, Kanazawa, Hisanori, Hoshiyama, Tadashi, Ito, Miwa, Kaneko, Shozo, Ogawa, Hisao
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.132.suppl_3.16789

BackgroundThe mechanisms how the activation within the pulmonary vein (PV) drives the atrial fibrillation (AF) has not been elucidated.ObjectivesTo define the AF maintenance mechanism by PV, we analyzed the activation sequence within the PV during AF.MethodsSelective endocardial mapping of the left superior PV (LSPV) was performed during AF in 11 patients with paroxysmal AF using a three-dimensional non-contact mapping system (EnSite 3000). In addition, we analyzed how the circumferential radiofrequency energy applications around the LSPV alter the activation of the LSPV and terminate AF.ResultsComplex fractionated electrograms (CFE) were observed at the second half of the proximal LSPV at the roof (n=5), ridge (n=11) and carina (n=7). Mean CFE area was 9.1±3.4 cm2, which occupied the 19.8% of the LSPV area. Frequent episodes of pivoting activation associated with wave break and fusion was observed at this CFE area. The frequency of pivoting activation around the functional conduction block, wave break and fusion at the CFE region were significantly higher than those at the non-CFE region (32.5±12.2 vs. 4.6±5.8 times/sec; p