Non-Invasive Estimates of Left Atrial Activation in a Patient with Dissociated Left Atrial Tachycardia following Ablation of Atrial Fibrillation

Pyotr Platonov, I. Nault, Martin Stridh, Fredrik Holmqvist, M. Haissaguerre

Research output: Chapter in Book/Report/Conference proceedingPaper in conference proceedingResearchpeer-review

Abstract

Introduction: Interatrial frequency gradient is used to guide catheter ablation of atrial fibrillation (AF) but reliable tools for its non-invasive estimation are lacking. We present a patient with dissociated left and right atrial rhythms that allows identification of sum face ECG leads that closely reflect left atrial activity. Methods: 12-lead ECG was recorded simultaneously with electrograms from the right and left atrial appendages (RAA/LAA). AF frequency spectra have been calculated from all 12 leads using spatiotemporal QRST cancellation and Welch periodogram. The dominating atrial cycle length (ACL) in the surface ECG leads was subsequently compared with ACL(LAA). Results: RAA and LAA cycle lengths were 1276 ins and 252 ins respectively. Of all surface ECG leads, AF frequency spectra in leads VI and aVR demonstrated the best agreement with ACL(LAA) showing prominent peaks corresponding to the LAA activation frequency. Conclusion: Leads VI and aVR contain a prominent left atrial component that has to be considered when interpreting fibrillatry activity from sum face ECG.
Original languageEnglish
Title of host publicationCINC: 2009 36TH Annual Computers In Cardiology Conference
PublisherIEEE - Institute of Electrical and Electronics Engineers Inc.
Pages133-136
ISBN (Print)978-1-4244-7281-9
Publication statusPublished - 2009
Event36th Annual Computers in Cardiology Conference, 2009 - Pk City, UT, Park City, UT, United States
Duration: 2009 Sep 132009 Sep 16
Conference number: 36

Publication series

Name
ISSN (Print)0276-6574

Conference

Conference36th Annual Computers in Cardiology Conference, 2009
Abbreviated titleCinC 2009
Country/TerritoryUnited States
CityPark City, UT
Period2009/09/132009/09/16

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

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