Simultaneous Biatrial Computerized Mapping During Permanent Atrial Fibrillation in Patients with Organic Heart Disease
Activations in Permanent Atrial Fibrillation. Introduction: Activation patterns during permanent atrial fibrillation (AF) in patients with organic heart diseases are unclear. Methods and Results: We studied six patients with permanent AF and organic heart diseases undergoing surgery. The duration of...
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Published in | Journal of cardiovascular electrophysiology Vol. 13; no. 6; pp. 571 - 577 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Science Inc
01.06.2002
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Subjects | |
Online Access | Get full text |
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Summary: | Activations in Permanent Atrial Fibrillation.
Introduction: Activation patterns during permanent atrial fibrillation (AF) in patients with organic heart diseases are unclear.
Methods and Results: We studied six patients with permanent AF and organic heart diseases undergoing surgery. The duration of AF averaged 4.9 ± 7.6 years. Computerized epicardial mappings of the right atrial (RA) free wall and the left atrial (LA) posterior wall were simultaneously performed with 224 bipolar electrodes at 3‐mm spatial resolution. In the RA, large wavefronts and conduction blocks were frequently observed. The lines of block correlated with the crista terminalis and large pectinate muscles. In contrast, the LA had rapid repetitive activities originated from corners of the electrode plaque, near the four pulmonary veins (PVs). On average, 2.8 ± 1.2 sites of rapid repetitive activities were identified per patient. They activated continuously, intermittently, or alternately during AF. The mean activation cycle length in the RA (196 ± 22 msec) was significantly longer than that in the LA (179 ± 26 msec; P = 0.004). The maximum dominant frequency in the LA was higher than that in the RA (6.41 ± 1.18 Hz vs 5.66 ± 0.55 Hz; P = 0.049). The maximum dominant frequency was consistently located in areas with rapid repetitive activations near the PVs.
Conclusion: During human permanent AF associated with organic heart diseases, the activation cycle length was shorter in the LA posterior wall than in the RA free wall. Rapid repetitive activities are consistently observed in the LA posterior wall, at or near the PVs. |
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Bibliography: | ark:/67375/WNG-C82W2QJL-R istex:E55B980B77EEDEC80E6EB6F3A2DB4F40416B72EE ArticleID:JCE571 This study was supported by a North American Society of Pacing and Electrophysiology Kenneth M. Rosen Fellowship Award to Dr. Doshi, grants from the American Heart Association, Dallas, Texas (1114‐G12, 9750623N, 9950464N), National Institutes of Health, Bethesda, Maryland (HL66389 and HL52319), University of California Tobacco Related Diseases Research Program, Berkeley, California (9RT‐0041), a Cedars‐Sinai ECHO Foundation Award to Dr. Karagueuzian, a Pauline and Harold Price Endowment to Dr. Chen, and the Ralph M. Parsons Foundation, Los Angeles, California. The first two authors contributed equally to this work. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1045-3873 1540-8167 |
DOI: | 10.1046/j.1540-8167.2002.00571.x |