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Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation
In atrial fibrillation (AF) patients, complex electrograms during sinus rhythm (C-EGMs) could be pathological or not. We aimed to demonstrate whether local pacing was helpful to discern pathological C-EGMs. 126 persistent AF patients and 27 patients with left-side accessory pathway (LAP) underwent l...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225993/ https://www.ncbi.nlm.nih.gov/pubmed/35739217 http://dx.doi.org/10.1038/s41598-022-14824-4 |
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author | Xu, Buyun Xu, Chao Sun, Yong Peng, Jiahao Peng, Fang Tang, Weiliang Zhou, Yan Wang, Shengkai Pan, Jie Xing, Yangbo |
author_facet | Xu, Buyun Xu, Chao Sun, Yong Peng, Jiahao Peng, Fang Tang, Weiliang Zhou, Yan Wang, Shengkai Pan, Jie Xing, Yangbo |
author_sort | Xu, Buyun |
collection | PubMed |
description | In atrial fibrillation (AF) patients, complex electrograms during sinus rhythm (C-EGMs) could be pathological or not. We aimed to demonstrate whether local pacing was helpful to discern pathological C-EGMs. 126 persistent AF patients and 27 patients with left-side accessory pathway (LAP) underwent left atrial mapping during sinus rhythm. If C-EGMs were detected, local pacing was performed. If the electrograms turned normal, we defined them as non-fixed C-EGMs, otherwise as fixed C-EGMs. No difference was detected in the incidence and proportion of non-fixed C-EGMs between AF patients and LAP patients (101/126 vs. 19/27, P = 0.26; 9.1 ± 6.0% vs. 7.7 ± 5.7%, P = 0.28). However, the incidence and proportion of fixed C-EGMs were higher in persistent AF patients (87/126 vs. 1/27, P < 0.01; 4.3 ± 3.4% vs. 0.1 ± 0.5%, P < 0.01). Compared with non-fixed C-EGMs, fixed C-EGMs had lower amplitudes, longer electrogram durations and longer Stimuli-P wave internals. All AF patients received circumferential pulmonary vein isolation. Among AF patients with fixed C-EGMs, 45 patients received fixed C-EGMs ablation and 42 patients underwent linear ablation. Compared with linear ablation, fixed C-EGMs ablation reduced recurrence (HR: 0.43; 95% CI 0.21‐0.81; P = 0.011). Among patients without fixed C-EGMs ablation, the proportion of fixed C-EGMs was an independent predictor of ablation outcomes (HR for per percent: 1.13, 95% CI 1.01–1.28, P = 0.038). C-EGMs could be classified into fixed and non-fixed C-EGMs through local pacing. Fixed rather than non-fixed C-EGMs might indicate abnormal atrial substrates and fixed C-EGMs ablation improve outcomes of persistent AF ablation. |
format | Online Article Text |
id | pubmed-9225993 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-92259932022-06-25 Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation Xu, Buyun Xu, Chao Sun, Yong Peng, Jiahao Peng, Fang Tang, Weiliang Zhou, Yan Wang, Shengkai Pan, Jie Xing, Yangbo Sci Rep Article In atrial fibrillation (AF) patients, complex electrograms during sinus rhythm (C-EGMs) could be pathological or not. We aimed to demonstrate whether local pacing was helpful to discern pathological C-EGMs. 126 persistent AF patients and 27 patients with left-side accessory pathway (LAP) underwent left atrial mapping during sinus rhythm. If C-EGMs were detected, local pacing was performed. If the electrograms turned normal, we defined them as non-fixed C-EGMs, otherwise as fixed C-EGMs. No difference was detected in the incidence and proportion of non-fixed C-EGMs between AF patients and LAP patients (101/126 vs. 19/27, P = 0.26; 9.1 ± 6.0% vs. 7.7 ± 5.7%, P = 0.28). However, the incidence and proportion of fixed C-EGMs were higher in persistent AF patients (87/126 vs. 1/27, P < 0.01; 4.3 ± 3.4% vs. 0.1 ± 0.5%, P < 0.01). Compared with non-fixed C-EGMs, fixed C-EGMs had lower amplitudes, longer electrogram durations and longer Stimuli-P wave internals. All AF patients received circumferential pulmonary vein isolation. Among AF patients with fixed C-EGMs, 45 patients received fixed C-EGMs ablation and 42 patients underwent linear ablation. Compared with linear ablation, fixed C-EGMs ablation reduced recurrence (HR: 0.43; 95% CI 0.21‐0.81; P = 0.011). Among patients without fixed C-EGMs ablation, the proportion of fixed C-EGMs was an independent predictor of ablation outcomes (HR for per percent: 1.13, 95% CI 1.01–1.28, P = 0.038). C-EGMs could be classified into fixed and non-fixed C-EGMs through local pacing. Fixed rather than non-fixed C-EGMs might indicate abnormal atrial substrates and fixed C-EGMs ablation improve outcomes of persistent AF ablation. Nature Publishing Group UK 2022-06-23 /pmc/articles/PMC9225993/ /pubmed/35739217 http://dx.doi.org/10.1038/s41598-022-14824-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Xu, Buyun Xu, Chao Sun, Yong Peng, Jiahao Peng, Fang Tang, Weiliang Zhou, Yan Wang, Shengkai Pan, Jie Xing, Yangbo Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation |
title | Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation |
title_full | Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation |
title_fullStr | Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation |
title_full_unstemmed | Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation |
title_short | Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation |
title_sort | fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225993/ https://www.ncbi.nlm.nih.gov/pubmed/35739217 http://dx.doi.org/10.1038/s41598-022-14824-4 |
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