IMPACT OF LEFT ATRIAL ANATOMY ON FREQUENCY OF …



IMPACT OF LEFT ATRIAL ANATOMY ON FREQUENCY OF COMPLEX FRACTIONATED ELECTROGRAMS

S. Verma1, N. Garg2, E. Charaf3

1Cardiology Consultants, Pensacola, FL, 2Yale University, New Haven, CT, 3University of South Alabama, Mobile, AL, USA

Introduction: Data correlating LA anatomy and electrophysiology findings is sparse. We hypothesized that enlargement of LA adversely impacts electrophysiological findings recorded during LA mapping and ablation for AF.

Methods: We prospectively collected electrophysiology data during LA mapping and ablation procedures in 113 patients with AF. Using pre-ablation cardiac CT data we collected LA volume and LA dimensions in cranio-caudal (CC), transverse lateral (TV) and antero-posterior directions (AP). Number of non-contiguous LA sites demonstrating complex fractionated electrograms (CFE) were recorded.

Results: Atria with larger number of CFE sites (from 0-3) show larger TV diameter. This relationship shows a linear correlation with correlation coefficient of (R 2 =0.98). This relationship is not true for CC or AP dimension. Also, there was no correlation between no of CFE sites and LA volume.

Conclusion: Increased no. of CFE sites correlates with enlargement of LA-TV dimension and not LA volume. It is possible that regional wall stress is greater in some sites of the LA that have a larger local wall radius and this results in pathogenesis manifested by CFE formation. This may suggest a role for LaPlace’s law in LA-CFE genesis.

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