Temporo-spatial stability of complex fractionated atrial electrograms in two distinct and separate episodes of paroxysmal atrial fibrillation

Ablation of complex fractionated atrial electrograms (CFAEs) during atrial fibrillation (AF) has been used as adjunct to contemporary techniques or as an alternative. Temporo-spatial stability of CFAE has been demonstrated in single episodes of AF. We examined temporo-spatial reproducibility of CFAE in two distinct episodes of AF. The left atrium (LA) was mapped using the EnSite (TM) system during an episode of induced or spontaneous AF in patients with paroxysmal AF. Sinus rhythm was restored with electrical cardioversion and maintained for 10 min before re-induction of AF and repeat mapping. Maps were compared examining the mean cycle length at identical vertices, provided the anatomical point had data on both maps. Complex fractionated atrial electrograms were considered stable if the compared electrogram was within 50 ms-delta to 120 ms + delta. Eleven patients were studied; 10 were included [3 female, mean age 59.5 years (32-76)]. Complex fractionated atrial electrograms were observed in all regions of the LA. Complex fractionated atrial electrograms were evenly distributed throughout the LA but most reproducible at the roof and antero-lateral wall. Complex fractionated atrial electrograms were highly conserved between two episodes of AF with 76.1 +/- 11.8% of CFAE reproducible at delta of 20 ms. Complex fractionated atrial electrograms are reproducible at the same anatomic site in a separate episode of AF.