title: Comparative distribution of complex fractionated atrial electrograms, high dominant frequency (HDF) sites during atrial fibrillation and HDF sites during sinus rhythm.
abstract: OBJECTIVE
  Complex fractionated atrial electrograms (CFAEs) and high dominant frequency sites during atrial fibrillation (AF-HDF) are related to the maintenance of atrial fibrillation (AF). HDF sites in sinus rhythm (SR-HDF; as defined by frequencies of >70 Hz) are suggested to be abnormal atrial tissue. Relations between these electrophysiologic signals have not been elucidated.
  
  
  METHODS
  We investigated the relations between SR-HDF and CFAE and AF-HDF sites during AF. NavX-based maps of CFAE and left atrium (LA)/pulmonary vein (PV) dominant frequency (DF) during AF and DF maps during SR were created for 23 patients with AF (paroxysmal AF (PAF), n = 14; persistent AF (PerAF), n = 9).
  
  
  RESULTS
  The extent of overlap between SR-HDF and CFAE sites was 51 ± 18 % (as calculated by the LA/PV segments containing both an SR-HDF site and a CFAE site/total LA/PV segments containing an CFAE site) and the extent of overlap between SR-HDF and AF-HDF sites was 50 ± 35 % (P = 0.7464). However, statistically poor agreement was noted for both (kappa values, 0.07 ± 0.19 and 0.08 ± 0.24, P = 0.8794). The extent of overlap did not differ between PAF and PerAF patients (SR-HDF and CFAE, 52 % (interquartile range (IQR), 42-59) versus 57 % (IQR, 33-67), P = 0.5842; SR-HDF and AF-HDF, 43 % (IQR, 25-85) versus 55 % (IQR, 13-83), P = 0.9465). The bipolar voltage amplitudes of SR-HDF, CFAE, and AF-HDF sites revealed normal voltage areas (1.6 mV (IQR, 0.8-2.7), 1.9 mV (IQR, 1.1-2.8), and 1.5 mV (IQR, 1.7-2.7), respectively).
  
  
  CONCLUSIONS
  In both PAF and PerAF, most CFAE and AF-HDF sites did not correspond to the SR-HDF sites or low-voltage area during SR. Thus, most CFAE and DF signals during AF represent functional electrical activities rather than structural remodeling of the atria.
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Ohyaguchi-kamicho, Itabashi-ku, Tokyo, Japan, 173-8610.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kofune
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Okumura
authors.forename: Ichiro
authors.initials: I
authors.lastname: Watanabe
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagashima
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Sonoda
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Mano
authors.forename: Rikitake
authors.initials: R
authors.lastname: Kogawa
authors.forename: Naoko
authors.initials: N
authors.lastname: Sasaki
authors.forename: Kimie
authors.initials: K
authors.lastname: Ohkubo
authors.forename: Toshiko
authors.initials: T
authors.lastname: Nakai
authors.forename: Mizuki
authors.initials: M
authors.lastname: Nikaido
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity