JACC: Basic to Translational Science, 8(1), 68–84p. (2023) DOI:10.1016/j.jacbts.2022.07.011
Regions of Highly Recurrent Electrogram Morphology With Low Cycle Length Reflect Substrate for Atrial Fibrillation
S. Yoo, M. Rottmann, J. Ng, D. Johnson, B. Shanab, A. Pfenniger, G. E. Geist, S. Mandava, A. Burrell, W. Zhang, A. Wasserstrom, B. P. Knight, R. S. Passman, J. J. Goldberger, R. AroraTraditional anatomically guided ablation and attempts to perform electrogram-guided atrial fibrillation (AF) ablation (CFAE, DF, and FIRM) have not been shown to be sufficient treatment for persistent AF. Using biatrial high-density electrophysiologic mapping in a canine rapid atrial pacing model of AF, we systematically investigated the relationship of electrogram morphology recurrence (EMR) (Rec% and CLR) with established AF electrogram parameters and tissue characteristics. Rec% correlates with stability of rotational activity and with the spatial distribution of parasympathetic nerve fibers. These results have indicated that EMR may therefore be a viable therapeutic target in persistent AF.
