{"id":"34eaf2fa18b4","type":"article","url":"https://hartvaat.nl/2019/01/01/hotspots-van-gefractioneerde-elektrogrammen-in-linker-en-rechter-atrium-bij-af/","title":"Hotspots van gefractioneerde elektrogrammen in linker en rechter atrium bij AF","title_en":"Anatomical hotspots of fractionated electrograms in the left and right atrium: do they exist?","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euy059","source_url":"https://doi.org/10.1093/europace/euy059","authors":["Roeliene Starreveld","Lisette J M E van der Does","Natasja M S de Groot"],"significance":4,"published":"2019-01-01","source_date":"2019-01-01","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/ritmecontrole-af/"],"congress":"","summary_en":"A structured literature review investigated anatomical hotspots of complex fractionated atrial electrograms during AF. The systematic mapping provides foundational data for understanding the rationale and limitations of CFAE-guided ablation strategies.","created":"2026-07-03T10:27:41Z","updated":"2026-07-03T18:38:41Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die anatomische hotspots van gefractioneerde elektrogrammen onderzocht bij AF. Fundamenteel voor de CFAE-ablatiestrategie.","abstract_original":"AIMS: Targeting of complex fractionated electrograms (CFEs) in the atria is not yet beneficial in treating drug-refractory atrial fibrillation (AF). In order to gain insight into potential anatomical hotspots of fractionated electrograms, a structured literature search was performed. METHODS AND RESULTS: PubMed was searched for studies describing fractionation during human atrial electrophysiological measurements (n = 565), of which 36 articles described the pre-ablation distribution of fractionated electrograms for the left atrium and/or right atrium in at least four regions. Fractionation was commonly found in high proportions within all regions of both atria, without clear preference for specific regions. Furthermore, no differences in the fractionation distribution between paroxysmal AF and persistent AF patients were observed. CONCLUSION: Whereas atrial inhomogeneous conduction is widely believed to play a key role in AF initiation and perpetuation, different electrophysiological causes for fractionation and the influence of measurement properties complicate identification of the arrhythmogenic substrate. Thereby, simply targeting all CFEs would be short-sighted. Further research is warranted on how to distinguish 'physiologic CFEs' from 'pathologic CFEs', with only the latter reflecting potential targets for ablative therapy of AF."}