Late gadolinium enhancement in areas with electrically fractionated potentials during sinus rhythm in patients with atrial fibrillation

• DOI: 10.1007/s00380-025-02515-9
• Publication Date: 2025-02-08T18:40:28Z
• Authors: Yuya Suzuki; Kunihiko Kiuchi; Mitsuru Takami; Kimitake Imamura; Jun Sakai; Toshihiro Nakamura; Atsusuke Yatomi; Yusuke Sonoda; Hiroyuki Takahara; Kazutaka Nakasone; Kyoko Yamamoto; Kenichi Tani; Hidehiro Iwai; Yusuke Nakanishi; Mitsuhiko Shoda; Shogo Yonehara; Atushi Murakami; Ken-ichi Hirata; Koji Fukuzawa

Abstract The areas with electrically fractionated potentials (AEFP) during sinus rhythm are related to non-pulmonary vein triggers and may serve as substrates of atrial fibrillation (AF) maintenance. However, the histological properties these compounds remain unclear. Therefore, we aimed evaluate late gadolinium enhancement (LGE) AEFP in patients AF. We enrolled 15 AF who had undergone LGE magnetic resonance imaging before catheter ablation. left atrium was detected using HD-Grid NavX systems after pulmonary isolation. compared between surrounding non-fractionated (non-AEFP). heterogeneity density were evaluated through entropy (LGE entropy) volume ratio voxel ratio), respectively. Thirty-three atrium. significantly higher than non-AEFP [LGE entropy: 6.2 (6.1–6.4) vs. 5.9 (5.8–6.0), p ≤ 0.0001; ratio: 23.0% (17.2–29.0%) 10.4% (3.4–20.2%), 0.0001]. voltages did not differ [2.4 (1.3–3.7) 2.5 (1.9–3.1) mV, = 0.96]. recurrence more found three those without it (log-rank test: 0.009). is likely be distributed heterogeneous moderate areas, regardless voltage.