Department of Medicine at the University of Vermont College of Medicine, Burlington, Vermont 05401, USA.
Heart Rhythm. 2010 May;7(5):586-93. doi: 10.1016/j.hrthm.2010.01.010. Epub 2010 Jan 11.
It has been proposed that sequential mapping of dominant frequency (DF) and complex fractionated atrial electrograms (CFAE) can identify target sites for ablation of atrial fibrillation (AF). These mapping strategies are valid only if DF and CFAE are temporally stable on the timescale of the mapping procedure. We postulate that DF and CFAE are temporally variable; consequently, sequential mapping can be misleading.
To make prolonged spatially stable multielectrode recordings to assess the temporal stability of DF and CFAE.
We recorded electrical activity for 5 minutes with the use of a 64-electrode basket catheter placed in the left atrium of 18 patients presenting for AF ablation. DF and CFAE were determined off-line, and their temporal variability was quantified. Maps created from simultaneous versus sequentially acquired data were compared.
DF was temporally variable: the average temporal coefficient of variation was 22.7% +/- 5.4%. DF sites were transient, meeting criteria for only 22.1 seconds out of 5 minutes. Similarly, CFAEs were transient (average duration of CFAE 8.8 +/- 11.3 seconds). DF and CFAE sequential maps failed to identify 93.0% +/- 12.4% and 35.9% +/- 14.9% of DF and CFAE sites, respectively.
Because of temporal variability, sequential DF and CFAE maps do not accurately reflect the spatial distribution of excitation frequency during any given sampling interval. The spatial distribution of DF and CFAE sites on maps created with sequential point acquisition depends upon the time at which each site is sampled.
已经有人提出，通过顺序标测主导频率（DF）和复杂碎裂心房电图（CFAE），可以找到房颤（AF）消融的靶位。只有在标测过程的时间尺度上，DF 和 CFAE 具有时间稳定性时，这些标测策略才是有效的。我们假设 DF 和 CFAE 是时间变化的；因此，顺序标测可能会产生误导。
进行长时间的空间稳定的多电极记录，以评估 DF 和 CFAE 的时间稳定性。
我们使用 64 电极篮状导管在 18 例因 AF 消融而就诊的患者的左心房内记录 5 分钟的电活动。离线确定 DF 和 CFAE，并对其时间变异性进行量化。比较同时和顺序采集数据创建的图。
DF 是时间变化的：平均时间变异系数为 22.7% +/- 5.4%。DF 部位是短暂的，仅在 5 分钟内满足标准 22.1 秒。同样，CFAE 也是短暂的（CFAE 的平均持续时间为 8.8 +/- 11.3 秒）。DF 和 CFAE 顺序图分别未能识别 93.0% +/- 12.4%和 35.9% +/- 14.9%的 DF 和 CFAE 部位。
由于时间变异性，顺序 DF 和 CFAE 图不能准确反映在任何给定的采样间隔内兴奋频率的空间分布。在使用顺序点采集创建的图上，DF 和 CFAE 部位的空间分布取决于每个部位被采样的时间。
