Electrophysiological Analysis of Chronic Atrial Fibrillation Associated with Mitral Valve Disease by Using Spectral Analysis

Imai Katsuhiko

Sueda Taijiro

Orihashi Kazumasa

Ishii Osamu

Matsuura Yuichiro

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

Several authors have suggested that periodic activation is related to maintenance of atrial fibrillation (AF). The aim of this study was to examine periodic electrical activations in both atria that may lead to the generation and maintenance of AF associated with valvular diseases by means of fast Fourier transform (FFT) analysis. Atrial electrograms (AEGs) were analyzed in 15 persistent AF patients, who underwent pulmonary vein orifice (PVO) isolation with mitral valve surgery. Intraoperatively, AEGs of 4 seconds duration were acquired at 48 epicardial sites, 24 each from the right and left atrium (RA, LA). Dominant peaks (DPs) examined using FFT were present in 26% of all sampling points (380/1440). Prominent clustering of DPs was mostly observed on the LA. The mean AF cycle length (mAFCL) estimated from DP frequency was significantly shorter in LA than that in RA (178 ± 32 msec vs 24 7 ± 58, p = 0.0003). The shortest AF cycle length in each patient was mainly found in the LA. The PVO isolation procedures successfully eliminated AF in 87% of patients (13/15). In cases of recurred AF (2/15), the difference in mAFCL between bilateral atria was significantly smaller than in the case of successful AF elimination (17 ± 7 msec vs 76 ± 56, p = 0.042). FFT analysis of intraoperative mapping data clarified that periodic activity was present predominantly in LA. It may be possible to predict the efficacy of surgical procedures for eliminating AF using this technique.

Chronic atrial fibrillation

Electrophysiology

Fast Fourier transform analysis

Surgical ablation

Medical sciences [ 490 ]

eng

Hiroshima University Medical Press

[ISSN] 0018-2052

[NCID] AA00664312