Document Detail


Mechanisms responsible for the initiation and maintenance of atrial fibrillation assessed by non-contact mapping system.
MedLine Citation:
PMID:  17434629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study is aimed to assess the initiation and maintenance mechanisms of atrial fibrillation (AF) and their relationships with the anatomical structures of the left atrium (LA) and pulmonary veins (PVs). METHODS: Thirty-seven patients (pts; 33 men, mean age 50+/-12, range 25-68 years) with paroxysmal AF (n=29) and persistent AF (n=8) who underwent mapping of the LA and PV using 3D non-contact endocardial mapping system (EnSite 3000) were included. Atrial premature complexes (APCs) which triggered the initiation of AF lasted longer than 1 min were mapped and the activation sequence on isopotential color maps was analyzed. RESULTS: Wave front dynamics and the relationship with the underlying anatomical structures were assessed. APCs from PV were related to the initiation of AF, but not to the maintenance of AF in 59.5% of the pts (focally triggered type) whereas APCs from PV not only initiated AF but also maintained AF without continuous triggering in 27% (focally driven type). Mixed type and indeterminate type of AF was in 4.5% and 13.5%, respectively. During AF, the mean number of wavelet was 1.45 (maximum 3 in 76.5%). Anatomical structures showing frequent wave break and slow conduction were mostly located at the septopulmonary bundle (86.5%) and the posterior LA roof between left superior PV and right superior PV (54.1%). CONCLUSION: Focal repetitive activity from PV played an important role in both initiation and maintenance of AF using NCM study. Specific anatomical structures such as septopulmonary bundle or posterior LA roof were associated with the spontaneous wave break and heterogeneous conduction delay, which was also appears to be important in the maintenance of AF.
Authors:
Seung-Woon Rha; Young-Hoon Kim; Mun Kyung Hong; Young Moo Ro; Cheol Ung Choi; Soon Yong Suh; Jin Won Kim; Eung Ju Kim; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh
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Publication Detail:
Type:  Journal Article     Date:  2007-04-16
Journal Detail:
Title:  International journal of cardiology     Volume:  124     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-04     Completed Date:  2008-03-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  218-26     Citation Subset:  IM    
Affiliation:
Cardiovascular Center, Korea University Guro Hospital 80, Guro-dong, Guro-gu, Seoul, Korea. swrha617@yahoo.co.kr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / diagnosis*,  surgery
Body Surface Potential Mapping / methods*
Catheter Ablation / methods
Electric Countershock / methods
Electrophysiologic Techniques, Cardiac*
Female
Heart Catheterization / methods
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Veins / physiopathology*
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Tachycardia, Paroxysmal / diagnosis*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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