Relationship between rotors and complex fractionated electrograms in atrial fibrillation using a novel computational...

Area of Science:

• Electrophysiology
• Cardiac Arrhythmia Research

Background:

• Rotors and complex fractionated atrial electrograms (CFAEs) are potential targets for atrial fibrillation (AF) ablation.
• Understanding the relationship between rotors and CFAEs is crucial for refining ablation strategies.

Purpose of the Study:

• To investigate the spatial relationship between rotors and CFAEs in patients with atrial fibrillation.
• To determine if the location of rotors and CFAEs overlap and assess the stability of CFAEs in these overlapping regions.

Main Methods:

• Endocardial mapping using a basket catheter in 18 AF patients undergoing ablation.
• Identification and localization of rotors and CFAEs using FIRM™ and CARTO™ systems with 30-second recordings.
• Classification of CFAEs stability (stable, moderately stable, unstable) based on frame presence.

Main Results:

• A total of 44 rotors and 60 CFAEs (39 stable) were identified.
• Rotors and CFAEs were found in the same location in 27/44 rotors and 20/39 stable CFAEs.
• Stable CFAEs were significantly more likely to be found at the same location as a focal rotor (63% vs. 37%, p=0.001).

Conclusions:

• Rotors and CFAEs frequently co-localize in the atria.
• The co-localization is more pronounced when considering only stable CFAEs.
• This spatial relationship has significant implications for selecting substrate targets during AF ablation procedures.