Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials
Abstract Background Fractionated atrial potential (FAP) during sinus rhythm (SR) may be a new target for ablation of atrial fibrillation (AF). However, the effects of the direction of activation and premature atrial contraction (PAC) on FAP is unknown. Therefore, we examined the impact of anisotropi...
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Wiley
2024-12-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.13161 |
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| author | Hideko Toyama Koichiro Kumagai |
| author_facet | Hideko Toyama Koichiro Kumagai |
| author_sort | Hideko Toyama |
| collection | DOAJ |
| description | Abstract Background Fractionated atrial potential (FAP) during sinus rhythm (SR) may be a new target for ablation of atrial fibrillation (AF). However, the effects of the direction of activation and premature atrial contraction (PAC) on FAP is unknown. Therefore, we examined the impact of anisotropic conduction and PAC on the distribution and areas of FAP. Methods FAP map in the left atrium was created in 40 patients with AF before ablation. The distribution and areas of FAP were compared during SR, distal coronary sinus (CS) pacing (S1) and extrastimulus (S2), and paced PAC after SR. FAP was defined as a potential with four or more fragmented deflections. Results FAPs during SR were found in the right and mid‐anterior walls and septum in most patients. During S1 compared to SR, FAPs significantly decreased in the right and mid‐anterior walls, appendage, septum, and right inferior wall, while significantly increased in the lateral wall. During S2 compared to S1, FAPs significantly increased in the mid anterior and right and mid posterior walls. During PAC compared to SR, FAPs significantly decreased in the right and mid anterior walls and roof, while significantly increased in the left anterior, left inferior and lateral walls. A rotational activation pattern at the FAP area during CS pacing was observed in 12 patients (30%), mostly in the left inferior wall. Conclusions The distribution and areas of FAP vary with anisotropic conduction and extrastimulus. Therefore, FAP should be evaluated not only during SR but also during extrastimulus from the distal CS. |
| format | Article |
| id | doaj-art-e460fe3f329c4ca39909e5d6318c99db |
| institution | DOAJ |
| issn | 1880-4276 1883-2148 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
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| series | Journal of Arrhythmia |
| spelling | doaj-art-e460fe3f329c4ca39909e5d6318c99db2025-08-20T02:50:01ZengWileyJournal of Arrhythmia1880-42761883-21482024-12-014061381138810.1002/joa3.13161Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentialsHideko Toyama0Koichiro Kumagai1Heart Rhythm Center Fukuoka Sanno Hospital Fukuoka JapanHeart Rhythm Center Fukuoka Sanno Hospital Fukuoka JapanAbstract Background Fractionated atrial potential (FAP) during sinus rhythm (SR) may be a new target for ablation of atrial fibrillation (AF). However, the effects of the direction of activation and premature atrial contraction (PAC) on FAP is unknown. Therefore, we examined the impact of anisotropic conduction and PAC on the distribution and areas of FAP. Methods FAP map in the left atrium was created in 40 patients with AF before ablation. The distribution and areas of FAP were compared during SR, distal coronary sinus (CS) pacing (S1) and extrastimulus (S2), and paced PAC after SR. FAP was defined as a potential with four or more fragmented deflections. Results FAPs during SR were found in the right and mid‐anterior walls and septum in most patients. During S1 compared to SR, FAPs significantly decreased in the right and mid‐anterior walls, appendage, septum, and right inferior wall, while significantly increased in the lateral wall. During S2 compared to S1, FAPs significantly increased in the mid anterior and right and mid posterior walls. During PAC compared to SR, FAPs significantly decreased in the right and mid anterior walls and roof, while significantly increased in the left anterior, left inferior and lateral walls. A rotational activation pattern at the FAP area during CS pacing was observed in 12 patients (30%), mostly in the left inferior wall. Conclusions The distribution and areas of FAP vary with anisotropic conduction and extrastimulus. Therefore, FAP should be evaluated not only during SR but also during extrastimulus from the distal CS.https://doi.org/10.1002/joa3.13161atrial fibrillationfractionated potentialhigh‐density mappingpremature atrial contraction |
| spellingShingle | Hideko Toyama Koichiro Kumagai Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials Journal of Arrhythmia atrial fibrillation fractionated potential high‐density mapping premature atrial contraction |
| title | Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials |
| title_full | Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials |
| title_fullStr | Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials |
| title_full_unstemmed | Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials |
| title_short | Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials |
| title_sort | impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials |
| topic | atrial fibrillation fractionated potential high‐density mapping premature atrial contraction |
| url | https://doi.org/10.1002/joa3.13161 |
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