{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:21:24Z","timestamp":1764688884439},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The characteristics of atrial electrograms associated with atrial fibrillation (AF) termination are controversial. We investigated the electrogram characteristics that indicate procedural AF termination during continuous complex fractionated electrogram ablation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Fifty-two consecutive patients with persistent AF (47 men; aged 54\u00b19 years), who underwent electrogram-based catheter ablation in the left atrium and coronary sinus after pulmonary vein isolation, were enrolled. The intracardiac bipolar atrial electrogram recordings were characterized by (1) fractionation interval (FI) analysis (&gt;6 seconds), (2) kurtosis (shape of the FI histogram), and (3) skewness (asymmetry of the FI histogram). Sites showing complex, fractionated electrograms (mean FI \u226460 ms) were targeted, and AF was terminated in 20 patients (38%) after the pulmonary vein isolation. The conventional complex fractionated electrogram sites (mean \u2264120 ms) in patients with AF termination exhibited higher median kurtosis (2.69 [interquartile range, 2.03\u20133.46] versus 2.35 [interquartile range, 1.79\u20132.48];\n              <jats:italic>P<\/jats:italic>\n              =0.024) and higher complex fractionated electrogram-mean interval (102.7\u00b119.8 versus 87.7\u00b115.0;\n              <jats:italic>P<\/jats:italic>\n              =0.008) than patients without AF termination. Furthermore, AF termination sites had higher median kurtosis than targeted sites without AF termination (5.13 [interquartile range, 3.51\u20136.47] versus 4.18 [interquartile range, 2.91\u20135.34];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01) in patients with procedural termination. In addition, patients with AF termination had a higher sinus rhythm maintenance rate after a single procedure than patients without AF termination (log-rank test,\n              <jats:italic>P<\/jats:italic>\n              =0.007).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>A kurtosis analysis using the FI histogram may be a useful tool in identifying the critical substrate for persistent AF and potential responders to catheter ablation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.111.967612","type":"journal-article","created":{"date-parts":[[2012,7,26]],"date-time":"2012-07-26T03:51:38Z","timestamp":1343274698000},"page":"949-956","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Novel Assessment of Temporal Variation in Fractionated Electrograms Using Histogram Analysis of Local Fractionation Interval in Patients With Persistent Atrial Fibrillation"],"prefix":"10.1161","volume":"5","author":[{"given":"Yenn-Jiang","family":"Lin","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyoshi","family":"Suenari","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Men-Tzung","family":"Lo","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan-Hsin","family":"Hsieh","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Lin","family":"Chang","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Wei","family":"Lo","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Feng","family":"Hu","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Chuan","family":"Cheng","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuki","family":"Kihara","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tze-Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beny","family":"Hartono","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsu-Juey","family":"Wu","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Shiang","family":"Lin","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke-Hsin","family":"Hsu","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambrose S.","family":"Kibos","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. L., K.S., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., B.H., A.S.K., S.-A.C.), Taipei, Taiwan; School of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University (Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-F.C., T.-J.W., S.-A.C.), Taipei, Taiwan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences (K.S., Y.K.), Hiroshima, Japan; Research Center for..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norden E.","family":"Huang","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Taipei Veterans General Hospital (Y.-J. 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