CLINICAL STUDY: ELECTROPHYSIOLOGY
Prolonged fractionation of paced right atrial electrograms in patients with atrial flutter and fibrillation
Ching-Tai Tai, MD*,
Shih-Ann Chen, MD*,
Jyh-Woei Tzeng, PhD ,
Benjamin I. Kuo, MD, PhD*,
Yu-An Ding, MD, PhD,
Mau-Song Chang, MD* and
Liang-Yu Shyu, PhD
* Division of Cardiology, Department of Medicine, National Yang-Ming University School of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Institute of Biomedical Engineering, Chung-Yuan Christian University, Chung-Li, Taiwan
Manuscript received October 5, 2000;
revised manuscript received January 9, 2001,
accepted January 24, 2001.
Reprint requests and correspondence: Dr. Ching-Tai Tai, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road, Taipei, Taiwan
cttai{at}vghtpe.gov.tw
OBJECTIVES
This study investigated the extent of fractionation of paced right atrial electrograms in patients with and without paroxysmal atrial flutter (AFL) or atrial fibrillation (AF).
BACKGROUND
Slow conduction through nonuniform anisotropic atrial muscles, represented by fractionated electrograms, may favor the generation of atrial tachyarrhythmias.
METHODS
This study included 10 control patients (Group 1), 8 patients with documented paroxysmal AFL (Group 2) and 10 patients with documented paroxysmal AF (Group 3). Five electrode catheters were placed in the different sites of the right atrium and one catheter was positioned at the coronary sinus ostium. Atrial pacing from one site was done by a constant drive train with an extrastimulus inserted every fourth beat while recording at the other five sites was performed. The delay of each fractionated potential in the high-pass filtered atrial electrogram in response to extrastimulation was determined and used to construct conduction curves of delay versus the S1S2 interval.
RESULTS
The mean increase in electrogram duration between a coupling interval of 350 ms and 10 ms above atrial refractoriness was significantly greater in Groups 2 and 3 compared with that in Group 1 (8.5 ± 2.5 vs. 11.0 ± 2.7 vs. 5.9 ± 2.3 ms, respectively, p < 0.001). The mean S1S2 interval at which delay increased suddenly was also longer in Groups 2 and 3 compared with Group 1 (326 ± 9 vs. 343 ± 12 vs. 307 ± 17 ms, respectively, p < 0.001).
CONCLUSIONS
Increased delays in the individual potential of the fractionated atrial electrograms may be related to the development of AFL and AF.
|
Abbreviations and Acronyms
| | AF | = atrial fibrillation | | AFL | = atrial flutter | | SVD | = singular value decomposition |
|
This article has been cited by other articles:
|
|
|
|
 
M. Pytkowski, A. Jankowska, A. Maciag, I. Kowalik, M. Sterlinski, H. Szwed, and R. C. Saumarez
Paroxysmal atrial fibrillation is associated with increased intra-atrial conduction delay
Europace,
December 1, 2008;
10(12):
1415 - 1420.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Liuba and H. Walfridsson
Focal atrial tachycardia: increased electrogram fractionation in the vicinity of the earliest activation site
Europace,
October 1, 2008;
10(10):
1195 - 1204.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al.
ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society
Europace,
September 1, 2006;
8(9):
651 - 745.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al.
ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society
J. Am. Coll. Cardiol.,
August 15, 2006;
48(4):
e149 - e246.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al.
ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society
Circulation,
August 15, 2006;
114(7):
e257 - e354.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Morita, K. Kusano-Fukushima, S. Nagase, Y. Fujimoto, K. Hisamatsu, H. Fujio, K. Haraoka, M. Kobayashi, S. T. Morita, K. Nakamura, et al.
Atrial fibrillation and atrial vulnerability in patients with Brugada syndrome
J. Am. Coll. Cardiol.,
October 16, 2002;
40(8):
1437 - 1444.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
