title: Real-time dominant frequency analysis of the pulmonary vein in patients with paroxysmal atrial fibrillation.
abstract: BACKGROUND
  Paroxysmal atrial fibrillation (PAF) can be treated with pulmonary vein isolation (PVI). A spectral analysis can identify sites of high-frequency activity during atrial fibrillation (AF). We investigated the role of the PVs on AF perpetuation by dominant frequency (DF) analysis.
  
  
  METHODS
  Thirty-one consecutive patients with PAF who underwent PVI were included in the prospective study. DF was calculated in each of the PVs, 16, five, and five sites in the left atrium, the coronary sinus, and the right atrium, respectively. In patients presenting sinus rhythm at the baseline, AF was induced by pacing. The PVs were then divided into two groups; PVs demonstrated the highest DF (HDF-PV) and others.
  
  
  RESULTS
  One patient was excluded from the analysis because sustained AF could not be induced. AF was terminated in 43.3% (13/30) of patients during ablation. Of 92 PVs isolated during AF, 30 and 62 PVs were classified into the HDF-PV and others, respectively. PAF was more frequently terminated by the HDF-PV isolation compared to the others (33.3% [10/30] vs 4.8% [3/62], P = 0.0004). Interestingly, nine of the 30 HDF-PVs showing the highest DF among all 30 regions, including extra PVs, led to AF termination in 88.9% (eight out of nine) of cases. Moreover, the HDF-PVs isolation resulted in a greater AF cycle length prolongation than the other PVs isolation (12.1±5.0 vs 2.7±7.6 ms, P = 0.007).
  
  
  CONCLUSIONS
  Termination of PAF was more frequently observed during ablation of the PVs with the highest DF. The PV showing high DF played an important role in the maintenance of PAF.
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan. mattsuu@tc4.so-net.ne.jp
authors: Seiichiro
authors: S
authors: Matsuo
authors: Teiichi
authors: T
authors: Yamane
authors: Taro
authors: T
authors: Date
authors: Ken-Ichi
authors: K
authors: Tokutake
authors: Mika
authors: M
authors: Hioki
authors: Keiichi
authors: K
authors: Ito
authors: Ryohsuke
authors: R
authors: Narui
authors: Shin-Ichi
authors: S
authors: Tanigawa
authors: Michifumi
authors: M
authors: Tokuda
authors: Seigo
authors: S
authors: Yamashita
authors: Keiichi
authors: K
authors: Inada
authors: Kosuke
authors: K
authors: Minai
authors: Kimiaki
authors: K
authors: Komukai
authors: Ken-Ichi
authors: K
authors: Sugimoto
authors: Michihiro
authors: M
authors: Yoshimura
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted