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Updated: Feb 3, 2026
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
34.1K
Unipolar electrogram-guided radiofrequency catheter ablation in paroxysmal atrial fibrillation: electrogram patterns
Guohua Fu1, Bin He1, Binhao Wang1
1From the Arrhythmia Center, Ningbo First Hospital, Liuting Road 59, Ningbo, 315000, Zhejiang, China.
Summary
Unipolar electrogram (UP-EGM) patterns vary across continuous circular lesions after radiofrequency catheter ablation (RFCA) for atrial fibrillation. UP-EGM guidance for pulmonary vein isolation in paroxysmal atrial fibrillation is effective, with 86% of patients remaining in sinus rhythm.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Transmural lesions (TLs) are critical for successful radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients.
- Complete positive unipolar electrogram (UP-EGM) post-ablation is linked to transmural lesion formation.
- UP-EGM patterns may vary within continuous circular lesions (CCLs) around pulmonary veins.
Purpose of the Study:
- To analyze distinct UP-EGM patterns in different regions of CCLs post-ablation.
- To evaluate the efficacy of UP-EGM guided RFCA for pulmonary vein isolation in paroxysmal atrial fibrillation (PAF).
Main Methods:
- 43 PAF patients underwent contiguous point-by-point RFCA for pulmonary vein isolation.
- UP-EGM was recorded using the ablation catheter.
- CCLs were divided into six regions, with two points analyzed per region for UP-EGM type.
Main Results:
- Complete bidirectional block achieved in all pulmonary veins.
- 1032 RFCA points with complete positive UP-EGM were collected.
- Distinct UP-EGM morphologies (R, rR', Rr', M) were identified, with M patterns prevalent in specific left CCL regions (anterosuperior, roof).
- Non-M patterns dominated other CCL regions, ranging from 63% to 88%.
Conclusions:
- The majority (72%) of post-ablation UP-EGM patterns are non-M types.
- UP-EGM guided pulmonary vein isolation demonstrates reliability in PAF patients, achieving successful outcomes.
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