Berntsen Rolf Franck, Cheng Alan, Calkins Hugh, Berger Ronald D
Department of Cardiology, Rikshospitalet University Hospital, Sognsvannsveien 20, 0027 Oslo, Norway.
Europace. 2009 Mar;11(3):316-23. doi: 10.1093/europace/eun307. Epub 2008 Nov 12.
Areas with complex fractionated electrograms are commonly targeted during ablation of persistent atrial fibrillation (AF). These signals are, however, found in most sampled areas of the left atrium (LA), implying the need for further differentiation.
Electrograms were recorded over 60 s at eight different LA endocardial sites in 10 patients with persistent AF, using a fully automated algorithm. These were analysed in sequential 2 s segments for activity, mean amplitude, continuous activity percentage, and dominant frequency (DF). All three time-domain measures differed significantly between the LA sites (P < 0.001), whereas DF did not. Activity, continuous activity percentage, and mean activity-amplitude were highest in the mid-coronary sinus and lowest on the posterior wall. In a pairwise analysis, there were significant differences in activity between all locations (P < 0.001-0.044). To visualize the spatiotemporal activity patterns, activity was plotted against amplitude. This revealed distinct activity patterns with large intra- and inter-individual differences.
There are significant activity gradients and distinct activity patterns within the LA in humans with persistent AF. Further work is required, however, to determine whether these findings signify areas with different roles and importance in AF maintenance.
在持续性心房颤动（AF）消融过程中，通常将具有复杂碎裂电图的区域作为靶点。然而，这些信号在左心房（LA）的大多数采样区域都能发现，这意味着需要进一步区分。
使用全自动算法，在10例持续性AF患者的8个不同LA心内膜部位记录60秒的电图。对这些电图按连续2秒的片段分析其活性、平均振幅、连续活性百分比和主导频率（DF）。所有三个时域指标在LA各部位之间存在显著差异（P<0.001），而DF无差异。活性、连续活性百分比和平均活性振幅在冠状窦中部最高，在后壁最低。在成对分析中，所有部位之间的活性存在显著差异（P<0.001 - 0.044）。为了直观显示时空活性模式，将活性与振幅作图。这揭示了不同的活性模式，个体内和个体间差异很大。
在持续性AF患者的LA内存在显著的活性梯度和不同的活性模式。然而，需要进一步研究以确定这些发现是否意味着在AF维持中具有不同作用和重要性的区域。
