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Volume 6, Issue 1, Pages (January 2009)

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1 Volume 6, Issue 1, Pages 11-17 (January 2009)
Relationship between the spectral characteristics of atrial fibrillation and atrial tachycardias that occur after catheter ablation of atrial fibrillation  Kentaro Yoshida, MD, Aman Chugh, MD, Magnus Ulfarsson, PhD, Eric Good, DO, Michael Kuhne, MD, Thomas Crawford, MD, Jean F. Sarrazin, MD, Nagib Chalfoun, MD, Darryl Wells, MD, Warangkna Boonyapisit, MD, Srikar Veerareddy, MD, Sreedhar Billakanty, MD, Wai S. Wong, MD, Krit Jongnarangsin, MD, Frank Pelosi, MD, Frank Bogun, MD, Fred Morady, MD, Hakan Oral, MD  Heart Rhythm  Volume 6, Issue 1, Pages (January 2009) DOI: /j.hrthm Copyright © 2009 Heart Rhythm Society Terms and Conditions

2 Figure 1 Periodogram of atrial fibrillation (AF) recorded in the coronary sinus at baseline (A), 3 minutes prior to conversion (B), and the frequency of atrial tachycardia (AT; C). At baseline, the dominant frequency (DF) of AF is 6.60 Hz (A). There is a spectral component with a frequency of 4.96 Hz (arrow). Ablation of complex fractionated atrial electrograms results in a decrease in DF of AF; however, there is no change in the frequency of the spectral component (B, arrow). After termination of AF to AT, the frequency of AT (4.84 Hz) is similar to the frequency of the spectral component identified in the periodogram of AF (C). The mechanism of AT was mitral isthmus–dependent flutter in this example. Cycle length is given in parentheses. Heart Rhythm 2009 6, 11-17DOI: ( /j.hrthm ) Copyright © 2009 Heart Rhythm Society Terms and Conditions

3 Figure 2 Conversion of atrial fibrillation (AF) to atrial tachycardia (AT). Shown are ECG leads I, II, III, aVF, and V1 intracardiac electrograms recorded from the distal bipole of an ablation catheter positioned in the left atrium (Abl) and distal bipole of a quadripolar catheter positioned in the coronary sinus (CS). Electrograms were recorded at baseline (A), 3 minutes before conversion to AT (B), during conversion of AF to AT (C) and during AT (D). During transition from AF to AT, the AF became more organized before converting to AT. At times during the ablation procedure, the degree of organization varied, suggesting a gradual effect of ablation on fibrillatory conduction. Heart Rhythm 2009 6, 11-17DOI: ( /j.hrthm ) Copyright © 2009 Heart Rhythm Society Terms and Conditions

4 Figure 3 Effect of ablation on dominant frequency (DF) of atrial fibrillation (AF). Shown are the DF of AF recorded in the coronary sinus (CS; hatched bars) and lead V1 (gray bars) at baseline and before conversion of AF to atrial tachycardia (AT) among patients in group I. The DF recorded from the CS and lead V1 were similar in all groups. Ablation resulted in a significant decrease in the DF of AF. However, the frequency of the spectral component in the periodogram of AF that matched AT and frequency of AT after conversion was similar. Heart Rhythm 2009 6, 11-17DOI: ( /j.hrthm ) Copyright © 2009 Heart Rhythm Society Terms and Conditions

5 Figure 4 Relationship between atrial fibrillation (AF) and atrial tachycardia (AT) recorded in the coronary sinus among patients in group I. There was a significant direct correlation between the dominant frequency (DF) of AF and the frequency of AT at baseline (A) and shortly before conversion to AT (B). Heart Rhythm 2009 6, 11-17DOI: ( /j.hrthm ) Copyright © 2009 Heart Rhythm Society Terms and Conditions

6 Figure 5 Relationship between atrial fibrillation (AF) and atrial tachycardia (AT) recorded in the coronary sinus among patients in group II. There was no significant relationship at baseline (A) or shortly before cardioversion to sinus rhythm (B). DF = dominant frequency. Heart Rhythm 2009 6, 11-17DOI: ( /j.hrthm ) Copyright © 2009 Heart Rhythm Society Terms and Conditions


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