Impact of left atrial appendage ridge ablation on the complex fractionated electrograms in persistent atrial fibrillation

• Published in: Journal of interventional cardiac electrophysiology 2014-10, Vol.41 (1), p.55-64
• Main Authors: Nakahara, Shiro, Hori, Yuichi, Hayashi, Akiko, Kobayashi, Sayuki, Nakamura, Hidehiko, Okumura, Yasuo, Takayanagi, Kan
• Format: Article
• Language: English
• Subjects: Atrial Appendage - surgery; Atrial Fibrillation - diagnosis; Atrial Fibrillation - surgery; Cardiology; Catheter Ablation - methods; Electrocardiography; Electrophysiologic Techniques, Cardiac; Female; Humans; Imaging, Three-Dimensional; Male; Medicine; Medicine & Public Health; Middle Aged; Recurrence; Tomography, Spiral Computed; Treatment Outcome
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1007/s10840-014-9902-2

Background The left atrial appendage (LAA) is a possible key contributor to the maintenance of persistent atrial fibrillation (PsAF). The effect of LAA ostial ablation on global left atrial higher-frequency sources remains unclear. Methods Complex fractionated electrograms (CFEs) and dominant frequency (DF) maps acquired with a NavX system in 58 PsAF patients were enrolled and examined before and after LAA posterior ridge ablation, which followed a stepwise linear ablation. Results High-density left atrial mapping identified continuous CFE sites in 50 % and high-DFs (≥8 Hz) in 53 % of patients at the LAA posterior ridge. In 44 patients in whom AF persisted despite pulmonary vein isolation (PVI) and linear ablation, LAA ablation significantly increased the mean CFE cycle length from 98 ± 29 to 108 ± 30 ms ( P