Document Detail

Multiple arrhythmogenic foci associated with the development of perpetuation of atrial fibrillation.
MedLine Citation:
PMID:  19996379     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The presence of multiple arrhythmogenic sources may be associated with the perpetuation of atrial fibrillation (AF). In this study, we investigated the hypothesis that multiple foci might be involved in the development of AF persistency.
METHODS AND RESULTS: Two hundred fourteen consecutive patients with AF undergoing catheter ablation were enrolled in this study. The location of the arrhythmogenic foci was determined using simultaneous recordings from multipolar catheters before and after pulmonary vein isolation during an isoproterenol administration. We detected 500 arrhythmogenic foci (263 foci as AF initiators, and 237 foci as non-AF initiators). High-dose isoproterenol infusions (ranging from 2 to 20 microg/min) revealed potential arrhythmogenic foci, especially non-pulmonary vein foci (55%). Persistent AF was more highly associated with an incidence of multiple (>2) foci than paroxysmal AF (88% versus 65%, P=0.002), and a multivariate analysis demonstrated that multiple foci (>2) were an independent contributing factor for persistent AF (odds ratio; 95% confidence interval, 4.69; 1.82 to 12.09, P<0.001). In paroxysmal AF, the number of foci was higher in patients with long-term AF (>24 hours) than in those with short-lasting AF (2.64+/-0.14 versus 1.77+/-0.16, P=0.001). In the persistent AF group, the patients with short-lasting AF (<12 months) had a greater number of foci than did those with long-term AF (>12 months) (3.62+/-0.15 versus 1.92+/-0.16, P=0.04).
CONCLUSIONS: Multiple foci were likely to be involved in the development of persistent AF. However, if AF persisted for >12 months, they may not have had a significant effect on the AF perpetuation.
Toshiya Kurotobi; Katsuomi Iwakura; Koichi Inoue; Ryusuke Kimura; Atsunori Okamura; Yasushi Koyama; Yuko Tosyoshima; Norihisa Ito; Kenshi Fujii
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Publication Detail:
Type:  Journal Article     Date:  2009-12-08
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  3     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-03-09     Revised Date:  2012-02-03    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  39-45     Citation Subset:  IM    
Cardiovascular Division, Sakurabashi Watanabe Hospital, Osaka, Japan.
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MeSH Terms
Atrial Fibrillation / diagnosis,  physiopathology*,  surgery
Catheter Ablation*
Electrophysiologic Techniques, Cardiac
Heart Catheterization
Heart Conduction System / physiopathology*
Isoproterenol / administration & dosage
Middle Aged
Sympathomimetics / administration & dosage
Tachycardia, Paroxysmal / diagnosis,  physiopathology,  surgery
Reg. No./Substance:
0/Sympathomimetics; 7683-59-2/Isoproterenol
Comment In:
Circ Arrhythm Electrophysiol. 2010 Feb;3(1):7-9   [PMID:  20160176 ]

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

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