Can the Characteristics of Complex Fractionated Atrial Electrogram after Pulmonary Vein Isolation in Atrial Fibrillation Predict the Clinical Outcome?

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Background: Complex fractionated atrial electrogram (CFAE) have become additional target sites in atrial fibrillation (AF). We clarified the characteristics of CFAE after pulmonary vein isolation (PVI) and clinical outcome. Methods: PVI was performed in 156 patients with AF, then AF was induced by isoproterenol and rapid pacing. CFAE mapping was performed using Ensite array or NavX system. Each fractionated electrograms were assessed by contact bipolar for a recording duration >5 seconds. The location of CFAE area were divided into 7 lesions (posterior wall, anterior wall, roof, septum, mitral ithmus, LAA, CS) and evaluated in the relationship with clinical outcome. Results: Total 114 CFAE areas in 38 patients with paroxysmal AF (n=17) and persistent AF (n=21) were successfully mapped, and observed in anterior wall (71%), septum (68%), LAA (68%). AF was recurred in 10 patients with PAF (n=3) and PEF (n=7) during 10 months of follow-up. There was not significantly different about the mean number of CFAE area (2.7 vs. 3.1) and the mean cycle length of CFAE (64.7 vs. 58.4 ms) among the patients with and without recurrence. Conclusions: CFAE areas in LA after PVI were observed mostly in anterior wall, septum and LAA. The characteristics of CFAE could not predict the recurrence of AF.