期刊
HEART RHYTHM
卷 6, 期 5, 页码 587-591出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2009.02.023
关键词
Fractionated electrograms; Age; Conduction velocity; Atrium
资金
- National Health and Medical Research Council (NHMRC) of Australia
- National Heart Foundation of Australia
- Cardiac Society of Australia and New Zealand
- NHMRC of Australia
- National Heart Foundation
- St Jude Medical, Medtronic, Bard Electrophysiology, and Biosense-Webster
BACKGROUND Fractionated atrial electrograms (CFAEs) have been implicated in the mechanism of atrial fibrillation (AF). The prevalence and distribution of CFAEs in normal populations have not been clearly defined. OBJECTIVE This study sought to determine the influence of age on CFAEs and investigate the relationship between CFAEs and the underlying atrial substrate. METHODS Twenty-one patients without structural heart disease underwent electroanatomic mapping of their right atrium (RA). Patients were categorized into 3 groups according to age: group A, patients <30 years (25.1 +/- 3.1 years, n = 7); group B, patients between 31 and 59 years (51.7 +/- 10.3 years, n = 6); group C, patients >60 years (66.9 +/- 7.7 years, n = 8). The proportion of points with CFAEs was analyzed for the high and tow septal RA, high and low lateral RA, and high and tow posterior RA. The mean atrial voltage and conduction velocity were assessed in each of these regions. RESULTS The percentage of CFAEs was greater in group C (14.6% +/- 7.7%) than in group A (2.7% +/- 2.1%; P = 0.001). The percentage of CFAEs in group B (8.5% +/- 3.5%) was not significantly different from that in group A (P = 0.21) and group C (P = 0.14). The CFAEs were predominantly located in the posterior RA and high septal RA. There were significant correlations between the proportion of CFAEs and age (R = 0.72; P < 0.01), atrial voltage (R = -0.57; P < 0.01), and conduction velocity (R = -0.73; P < 0.001). CONCLUSION CFAEs increase with age and occur in regions of Low atrial voltage and slowed conduction. The distribution of CFAE is predominantly along the posterior and high septal RA, regions where there are marked changes in myocardial fiber orientation. This suggests that the underlying myocardial architecture is the main influence on electrogram morphology.
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