Prolonged and fractionated right atrial electrograms during sinus rhythm in patients with paroxysmal atrial fibrillation and sick sinus node syndrome

Abstract

Intraatrial catheter mapping of the right atrium was performed during sinus rhythm in 92 patients: Group I = 43 control patients without paroxysmal atrial fibrillation or sick sinus node syndrome; Group II = 31 patients with paroxysmal atrial fibrillation but without sick sinus node syndrome; and Group III = 18 patients with both paroxysmal atrial fibrillation and sick sinus node syndrome. Atrial electrograms were recorded at 12 sites in the right atrium. The duration and number of fragmented deflections of the atrial electrograms were quantitatively measured. The mean duration and number of fragmented deflections of the 516 atrial electrograms in Group I were 74 +/- 11 ms and 3.9 +/- 1.3, respectively. The criteria for an abnormal atrial electrogram were defined as a duration of greater than or equal to 100 ms or eight or more fragmented deflections, or both. Abnormal atrial electrograms were observed in 10 patients (23.3%) in Group I, 21 patients (67.7%) in Group II and 15 patients (83.3%) in Group III (Group II versus Group I, p less than 0.001; Group III versus Group I, p less than 0.001). The mean number of abnormal electrograms per patient with an abnormal electrogram was 1.3 +/- 0.7 in Group I, 2.5 +/- 1.9 in Group II and 3.5 +/- 2.5 in Group III (Group I versus Group II, p less than 0.01; Group II versus Group III, p less than 0.05). A prolonged and fractionated atrial electrogram characteristic of paroxysmal atrial fibrillation can be closely related to the vulnerability of the atrial muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Voltage and activation mapping. how the recording technique affects the outcome of catheter ablation procedures in patients with congenital heart disease

“…14 -16 Furthermore, the recording technique applied (unipolar or bipolar recordings), mapping catheters used (type of electrodes, electrode spacing), and filter settings of the amplifiers have considerable influence on the resulting activation and voltage maps. [17][18][19][20][21][22] Most studies comparing unipolar and bipolar signals are based on animal experiments or computer simulation studies, and only a few clinical studies have been reported. [13][14][15] We evaluated the effects of the recording technique applied on voltage and activation map reconstruction in 4 groups of patients with and without CHD, using the 3D CARTO mapping system.…”

Marcadores eletrocardiográficos para detecção precoce de doença cardíaca em pacientes com talassemia beta maior

“…18 In addition, it is now well accepted that a new and simple electrocardiographic marker, PWD, also represents inhomogeneous and discontinuous atrial conduction and has predictive value especially for paroxysmal atrial fibrillation. [19][20][21] In healthy children, P-wave duration has been reported to range from 50 to 100 ms. 22 PWD has been studied in some other cardiac conditions such as atrial enlargement, obesity, hypertension, atrial septal defect, pulmonary stenosis, and dilated cardiomyopathy. [23][24] Tükek et al 25 reported that increased sympathetic activity leads to a significant elevation in PWD.…”

Remodelagem atrial elétrica reversa após cardioversão de fibrilação atrial isolada de longa duração

“…Other studies have demonstrated a strong correlation between fractionated endocardial electrograms and AF episodes 33,34 . Fragmented ventricular activation detected by endocardial electrograms has been already correlated with low-amplitude and high-frequency signals detected on body surface SAECG 35,36 .…”