Effect of flecainide on the extension and localization of complex fractionated electrogram during atrial fibrillation. (June 2015)

• Record Type: Journal Article
• Authors: De Bortoli, Alessandro; Shi, Li-Bin; Wang, Yu-Chuan; Hoff, Per Ivar; Solheim, Eivind; Ohm, Ole-Jørgen; Chen, Jian
• Is Part Of: Scandinavian cardiovascular journal. Volume 49:Number 3(2015:Jun.)
• Page Start: 168
• Page End: 175
• Publication Date: 2015-06
• Subjects: Cardiovascular system -- Diseases -- Periodicals; 617.41
• DOI: 10.3109/14017431.2015.1036920
• Languages: English
• ISSNs: 1401-7431

Abstract

<abstract> <title>Abstract</title> <p> <italic>Aims</italic>. Complex fractionated electrogram (CFE) ablation in addition to pulmonary vein isolation is an accepted strategy for the treatment of non-paroxysmal atrial fibrillation (AF). We sought to determine the effect of flecainide on the distribution and extension of CFE areas. <italic>Methods.</italic> Twenty-three non-paroxysmal AF patients were enrolled in this prospective study. A first CFE map was obtained under baseline conditions by sampling 5 s of continuous recording from the distal electrodes of the ablation catheter. Intravenous flecainide (1 mg/kg) was administered over 10 min and followed by 30-min observation time. A second CFE map was obtained with the same modalities. CFE-mean values, CFE areas, and atrial electrogram amplitude were retrieved from the electro-anatomical mapping system (Ensite NavX). <italic>Results.</italic> After flecainide administration, CFE-mean values increased (111.5 ± 55.3 vs. 132.3 ± 65.0 ms, <italic>p</italic> < 0.001) with a decrease of CFE area (32.9%) in all patients. Atrial electrogram amplitude decreased significantly (0.30 ± 0.31 vs. 0.25 ± 0.20 mV, <italic>p</italic> < 0.001). We observed 80.9% preservation of CFE areas. A CFE mean of 78 ms was the best cutoff for predicting stable CFE areas. <italic>Conclusions.</italic> Flecainide reduces the extension of CFE areas while preserving their spatial localization. A CFE-mean value <80 ms may be crucial to define and locate stable CFE areas.</p> </abstract>