Arrhythmias & electrophysiology
High Dominant Frequencies and Fractionated Potentials Do Not Indicate Focal or Rotational Activation During Atrial Fibrillation (AF)
Authors' conclusion
Focal or rotational patterns of activation were not consistently detected at DFmax domains and CFAEmax sites.
Study context
- Population
- Patients with AF undergoing epicardial high-resolution mapping of right and left atrium incl. Bachmann's bundle
- Participants
- 71 patients
- Comparison
- DFmax and CFAEmax sites vs non-DFmax and non-CFAEmax sites
- Outcome
- Patterns of activation (focal, rotational, smooth propagation, conduction block, collision, remnant activity) and potential types underlying DF and CFAE sites
Methodological detailsepicardial high-resolution mapping
- Epicardial high-resolution mapping
Main finding
As reported in the abstract
Activation patterns and potential types (median proportions)
| Group | Focal waves | Smooth propagation | Conduction block | Single potentials | Fractionated potentials | Focal activation | Remnant activity |
|---|---|---|---|---|---|---|---|
| DFmax | 0% [IQR: 0%-2%] | 22% [IQR: 7%-48%] | 69% [IQR: 51%-81%] | 72% [IQR: 55%-84%] | 4% [IQR: 1%-11%] | ||
| non-DFmax | 17% [IQR: 11%-24%] | 74% [IQR: 69%-78%] | 6%1 [IQR: 55%-65%] | 12% [IQR: 9%-15%] | |||
| CFAEmax | 1% [IQR: 0%-1%] | 52% [IQR: 43%-66%] | 1% [IQR: 0%-2%] | 20% [IQR: 12%-29%] | |||
| non-CFAEmax | 17% [IQR: 12%-24%] | 12% [IQR: 9%-14%] | 8% [IQR: 5%-10%] |
Focal waves
DFmax0% [IQR: 0%-2%]
non-DFmaxNot reported in the abstract
CFAEmaxNot reported in the abstract
non-CFAEmaxNot reported in the abstract
Smooth propagation
DFmax22% [IQR: 7%-48%]
non-DFmax17% [IQR: 11%-24%]
CFAEmax1% [IQR: 0%-1%]
non-CFAEmax17% [IQR: 12%-24%]
Conduction block
DFmax69% [IQR: 51%-81%]
non-DFmax74% [IQR: 69%-78%]
CFAEmaxNot reported in the abstract
non-CFAEmaxNot reported in the abstract
Single potentials
DFmax72% [IQR: 55%-84%]
non-DFmax6%1 [IQR: 55%-65%]
CFAEmaxNot reported in the abstract
non-CFAEmaxNot reported in the abstract
Fractionated potentials
DFmax4% [IQR: 1%-11%]
non-DFmax12% [IQR: 9%-15%]
CFAEmax52% [IQR: 43%-66%]
non-CFAEmax12% [IQR: 9%-14%]
Focal activation
DFmaxNot reported in the abstract
non-DFmaxNot reported in the abstract
CFAEmax1% [IQR: 0%-2%]
non-CFAEmaxNot reported in the abstract
Remnant activity
DFmaxNot reported in the abstract
non-DFmaxNot reported in the abstract
CFAEmax20% [IQR: 12%-29%]
non-CFAEmax8% [IQR: 5%-10%]
- DFmax vs non-DFmax: P = 0.001 — smooth propagation
- DFmax vs non-DFmax: P = 0.006 — conduction block
- DFmax vs non-DFmax: P = 0.003 — single potentials
- DFmax vs non-DFmax: P = 0.004 — fractionated potentials
- CFAEmax vs non-CFAEmax: P < 0.001 — smooth propagation
- CFAEmax vs non-CFAEmax: P < 0.001 — remnant activity
- CFAEmax vs non-CFAEmax: P < 0.001 — fractionated potentials
Original publication
High Dominant Frequencies and Fractionated Potentials Do Not Indicate Focal or Rotational Activation During AF. JACC Clin Electrophysiol. Published 22 March 2023. doi:10.
Summarised from the published abstract; every number is checked against it