Right Atrial Continuous Fractionated Electrograms in Patients with Long-Standing Persistent Atrial Fibrillation

Jong Il Choi, Yae Min Park, Ji Eun Ban, Ra Seung Lim, Hyun Soo Lee, Kyoung Hee Lee, Nagamoto Yasutsugu, Jae Seung Jeong, Jae Seok Park, Hong Euy Lim, Sang Weon Park, Young Hoon Kim

Research output: Contribution to journalArticlepeer-review


Hypothesis: Continuous fractionated electrograms of the right atrium (RA-CFE) before ablation can predict clinical outcome of biatrial ablation. Methods: Consecutive 122 patients (56 ±9 years, 84% male) with longstanding persistent atrial fibrillation (AF) were enrolled. Catheter ablation at left atrium (LA) including electrical isolation of 4 pulmonary vein was performed in 70 patients (LA ablation), and electrograms-guided ablation at RA was performed in whom AF was not terminated after LA ablation (n=52, bi-atrial ablation). RA-CFE (+) was defined by >90 fractionation without isoelectric period for 30 seconds at crista terminalis and RA septum. Results: RA-CFE (+) at baseline was observed in 41.4% of LA ablation and in 67.3% of bi-atrial ablation group (p=0.006). Conversion rate to sinus rhythm by LA ablation was significantly lower in RA-CFE (+) than in RA-CFE (-) (69.0% vs 82.9%, p<0.001). During the mean 6-month, in patients with RA-CFE (+), freedom from recurrence was significantly higher in bi-atrial ablation than in LA ablation (71.4% vs 69.0%, p=0.009). RA-CFE (+) was associated with the recurrence after biatrial ablation (HR 3.646, 95% CI 1.288-10.324, p=0.015). Conclusions: RA ablation provides an increment in efficacy among patients with longstanding persistent AF who shows continuous fractionaed electrograms in RA. RA-CFE is a good predictor in identifying whom RA ablation for longstanding persistent AF is beneficial.

Original languageEnglish
Pages (from-to)408
Number of pages1
Journaljournal of arrhythmia
Issue number4
Publication statusPublished - 2011


  • atrial fibrillation
  • fractionated electrogram
  • right atrium

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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