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Identification of CFAE in AF patients by mechano – anatomical mapping

Identification of CFAE in AF patients by mechano – anatomical mapping. Montawatt Amnueypol, MD; Oraporn See, MD, FACC, FASE; Sukit Yamwong, MD; Tachapong Ngarmukos, MD, FACC; Sirin Apiyasawat, MD, FACC; Pakorn Chandanamattha, MD; Tarinee Tangcharoen, MD; Charaslak Charoenpanichkit , MD.

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Identification of CFAE in AF patients by mechano – anatomical mapping

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  1. Identification of CFAE in AF patients by mechano – anatomical mapping Montawatt Amnueypol, MD; Oraporn See, MD, FACC, FASE; Sukit Yamwong, MD; Tachapong Ngarmukos, MD, FACC; Sirin Apiyasawat, MD, FACC; Pakorn Chandanamattha, MD; Tarinee Tangcharoen, MD; Charaslak Charoenpanichkit , MD. Cardiovascular Unit, Department of Medicine, Ramathibodi hospital. Electro – Anatomical Mapping Triggers *PV, SVC, Ligament of Marshall, CS, Crista terminalis Complex Fractionated AtrialElectrograms (CFAE) Perpetuates (Substrates) Conduction↓, ERP↓, AP duration ↓, AP plateau Mechanism of Atrial Fibrillation. Electro – Anatomical Mapping was used to locate CFAE foci for ablation in 3D cardiac anatomy. • Purpose • This study aim to validate relationship between CFAM identified by mechano – anatomical mapping and CFAE by electro – anatomical mapping. • Population • Five AF patients were enrolled from Jan to Dec 2008. • Mean age 48±10.67 yrs and AF duration 6 (3 – 13) yrs • Results • Total 45 sites from LA and RA were analyzed. Our study showed significant high agreement between both CFAE and CFAM maps, with Kappa 0.758 (p – value <0.001). Sensitivity 94%, Specificity 92%, PPV 97%, NPV 86%, Positive LR 11.75, Negative LR 0.07 • Conclusion • Complex fractionated electrograms (CFAEs) in patients with spontaneous AF can be identified with precision non-invasively, using combination of TDI and 3D echocardiography. Method Mechanogram by Tissue Doppler Imaging had shown significantly correlated with electrogram in AF patients. Mechano – Anatomical mapping Electro – Anatomical mapping Complex Fractionated Atrial Mechanogram (CFAM) It is non – invasive and practical procedure and to be used in selecting and targeting foci for catheter ablation. CFAM were scored by two Echocardiographers. CFAE were scored by two Electrophysiologists Compare CFAM vs CFAE scores (0 – 2) in each sites (9 sites/case) by Kappa agreement Combination of Echocardiographic TDI’s mechanogram and 3D’s anatomy created novel mapping called CFAM used in targeting foci for ablation. Mechano – Anatomical Mapping

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