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Updated: May 22, 2026
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Stability of complex fractionated atrial electrograms: a systematic review
Dennis H Lau1, Bart Maesen, Stef Zeemering
1Department of Physiology, Maastricht University, Maastricht, The Netherlands.
Journal of Cardiovascular Electrophysiology
|May 5, 2012
Summary
Complex fractionated atrial electrograms (CFAE) are temporally variable, challenging their use in atrial fibrillation (AF) ablation. This variability impacts the effectiveness of CFAE-guided substrate modification strategies in AF patients.
Area of Science:
- Electrophysiology
- Cardiac Arrhythmias
- Medical Imaging and Diagnostics
Background:
- The efficacy of complex fractionated atrial electrograms (CFAE) ablation for atrial fibrillation (AF) is inconsistent.
- Concerns about the temporal stability of CFAE challenge the reliability of sequential CFAE mapping.
- Previous studies on CFAE stability are limited in scope and definition.
Purpose of the Study:
- To systematically review existing literature on the temporal stability of CFAE.
- To address controversial findings regarding CFAE stability in patients with AF.
- To evaluate the impact of CFAE variability on ablation strategies.
Main Methods:
- Systematic literature search conducted up to September 1, 2011.
- Inclusion of 7 studies assessing temporal CFAE stability in 96 AF patients.
- Analysis of varying CFAE mapping techniques and definitions.
Main Results:
- CFAE stability averaged 81% between sequential maps (19-minute interval) but 75% in shorter recordings (75 seconds).
- While CFAE cycle length variability was small (12-15 ms), electrical activity variation was high (up to 300%).
- Spatial distribution of CFAE was stable, but sequential mapping may miss dynamic CFAE sites.
Conclusions:
- Complex fractionated atrial electrograms (CFAE) exhibit temporal variability due to diverse underlying mechanisms.
- The dynamic nature of CFAE presents ongoing challenges for identifying critical ablation sites in AF.
- Understanding CFAE temporality is crucial for improving AF ablation outcomes.
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