title: Characteristics of complex fractionated atrial electrogram in the electroanatomically remodeled left atrium of patients with atrial fibrillation.
abstract: BACKGROUND
  Complex fractionated atrial electrogram (CFAE) guided ablation is effective in some patients with persistent atrial fibrillation (PeAF), but the pattern of CFAE may be different in the remodeled left atrium (LA).
  
  
  RESULTS
  In 100 AF patients (83 males, 55.0+/-10.6 years old) with AF (51 paroxysmal AF (PAF), 49 PeAF) who underwent catheter ablation, CFAE cycle length (CL) and distribution (NavX 3D map) were compared according to the LA volume (3D-CT) and endocardial voltage (during high right atrial pacing 500-ms (Vol(PACE)) and AF (Vol(AF); NavX). The mean CFAE-CL was longer (P=0.003) and the % area CFAE was smaller (P=0.006) in patients with LA >or=125 ml than those with <125 ml. The mean CFAE-CL was longer in patients with Vol(PACE) <1.7 mV than those with >or=1.7 mV (P=0.002) and in Vol(AF) <0.7 mV than >or=0.7 mV (P<0.001). The % area CFAE was smaller in patients with Vol(PACE) <1.7 mV than those with >or=1.7 mV (P=0.006). The incidence of septal CFAE was consistently high, regardless of the degree of LA remodeling.
  
  
  CONCLUSIONS
  In the AF patients with an electroanatomically remodeled LA, the % area of CFAE was smaller and mean CFAE-CL was longer than in those with a less remodeled LA. However, the majority of CFAE are consistently positioned on the septum in the remodeled LA.
authors.affiliation: Yonsei University Health System, Seoul, Korea.
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
authors.forename: Sang Weon
authors.initials: SW
authors.lastname: Park
authors.forename: Jong Youn
authors.initials: JY
authors.lastname: Kim
authors.forename: Sook Kyoung
authors.initials: SK
authors.lastname: Kim
authors.forename: Boyoung
authors.initials: B
authors.lastname: Jeoung
authors.forename: Moon-Hyung
authors.initials: MH
authors.lastname: Lee
authors.forename: Chun
authors.initials: C
authors.lastname: Hwang
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Sung Soon
authors.initials: SS
authors.lastname: Kim
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome