Characterization of drivers maintaining atrial fibrillation: Correlation with markers of rapidity and organization on spectral analysis

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Shohreh HonarbakhshRoss J Hunter

Abstract

Better characterization of drivers in atrial fibrillation (AF) may facilitate their identification. The purpose of this study was to demonstrate that certain driver characteristics are associated with greater mechanistic importance in maintaining AF. Persistent AF was mapped in patients using the CARTOFINDER system with a 64-pole basket catheter to identify and ablate drivers with rotational or focal activity after pulmonary vein isolation. An ablation response was defined as cycle length (CL) slowing ≥30 ms or AF termination. Driver sites with an ablation response were correlated to sites of fastest CL, highest dominant frequency (DF), and greatest organization (lowest cycle length variability [CLV] and highest regularity index [RI]). Parameters predicting AF termination with driver ablation were evaluated. All 29 patients had ≥1 driver identified. Forty-four potential drivers were identified. The predefined ablation response occurred with 39 drivers (89%): 23 rotational and 16 focal. During a 30-second recording, each driver occurred 8.7 ± 5.4 times and completed 3.1 ± 0.9 consecutive repetitions per occurrence. Driver sites correlated best with markers of organization, corresponding to the site of lowest CLV (29/39 [74%]) an...Continue Reading

Citations

Sep 26, 2019·Journal of Cardiovascular Electrophysiology·Shohreh HonarbakhshRoss J Hunter
Feb 13, 2020·Journal of Cardiovascular Electrophysiology·Gurpreet S DhillonRoss J Hunter
Sep 10, 2020·Circulation. Arrhythmia and Electrophysiology·Shohreh HonarbakhshRoss J Hunter
Jul 20, 2019·JACC. Clinical Electrophysiology·Shohreh HonarbakhshRichard J Schilling
Mar 22, 2021·Cardiovascular Research·Jorge G QuintanillaDavid Filgueiras-Rama
Jul 15, 2021·Journal of Cardiovascular Electrophysiology·Tina BaykanerJunaid Zaman

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