Document Detail


Electrophysiologic characteristics of paroxysmal and chronic atrial fibrillation in human right atrium.
MedLine Citation:
PMID:  11583895     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of the study was to analyze the electrophysiologic characteristics of paroxysmal (PAF) and chronic (CAF) atrial fibrillation (AF) in the human right atrium (RA). BACKGROUND: Differences that exist between PAF and CAF and the mechanisms of self-sustenance of these arrhythmias are incompletely understood. METHODS: A total of 53 patients with PAF (25 patients, mean age 59 +/- 6.1 years, 3 women) and CAF (28 patients, mean age 59 +/- 13 years, 7 women) underwent multisite mapping of the RA during ongoing AF using a 64-electrode basket catheter. Quantitative evaluation and three-dimensional activation patterns were performed using a computerized system. RESULTS: Patients with PAF, as compared with patients with CAF, had significantly longer AF cycle length, shorter time intervals with type III AF throughout the RA and a smaller number of endocardial breakthroughs (mean 51 +/- 19 vs. 104 +/- 40, p < 0.001). The majority of endocardial breakthrough points (88% in PAF patients and 98% in CAF patients) were located in the septal region and coincided anatomically with major interatrial connection routes. Coexistence of re-entrant and apparently focal activation determined maintenance of AF in the RA in PAF, whereas random re-entry was documented more frequently in patients with CAF. In patients with CAF, the duration of arrhythmia (in years) correlated strongly with the percentage of time during which type III AF was observed in the lateral wall of the RA (r = 0.71). CONCLUSIONS: Clinical PAF and CAF, as recorded in the RA, have, at least quantitatively, distinct electrophysiologic features and different mechanisms of maintenance.
Authors:
B Zrenner; G Ndrepepa; M R Karch; M A Schneider; J Schreieck; A Schömig; C Schmitt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  38     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-03     Completed Date:  2001-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1143-9     Citation Subset:  AIM; IM    
Affiliation:
Deutsches Herzzentrum München and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Zrenner@dhm.mhn.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / physiopathology*
Chronic Disease
Electrocardiography
Female
Fluoroscopy
Heart Atria / physiopathology*
Humans
Male
Middle Aged

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