Document Detail

Regional disparities of endocardial atrial activation in paroxysmal atrial fibrillation.
MedLine Citation:
PMID:  8945085     Owner:  NLM     Status:  MEDLINE    
Previous experimental data suggest that atrial activity is homogeneously distributed during paroxysmal atrial fibrillation (AFib). Little is known about this in human paroxysmal AFib. METHODS: Twenty-five men and two women (mean age 49 +/- 11 years; five with structural heart disease) with paroxysmal AFib for a mean 5 +/- 6.2 years despite the use of a mean of 3.6 +/- 1.7 antiarrhythmic drugs underwent atrial mapping. The right atrium was divided into four regions: posterior (intercaval), lateral, anterior, and septal. A 14-pole catheter was positioned to assess complex electrical activity defined as the duration of continuous electrical activity or electrograms with FF intervals < 100 ms for 60 seconds (expressed as percentage of time). In addition, the left atrium (divided into three regions: posterior, anterior, and septal) was explored in 12 patients with a multipolar catheter. RESULTS: The complex electrical activity time between all the regions explored was significantly different. In the right atrium, the septal (74% +/- 32%; P = 0.02) and the posterior (63% +/- 32%; P = 0.04) areas were significantly more disorganized than the lateral (22% +/-23%) and anterior (21% +/- 26%) regions. In the left atrium, complex electrical activity was predominant and widely distributed (posterior: 87% +/- 11%; septal: 65% +/- 27%) except in the appendage area (anterior region: 18% +/- 14%). CONCLUSIONS: Quantitative assessment of complex electrical activity in both atria in humans shows heterogeneous temporal and spatial distribution. This may have implications for guiding catheter ablation of AFib.
P Jaïs; M Haïssaguerre; D C Shah; S Chouairi; J Clémenty
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  19     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-03-06     Completed Date:  1997-03-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1998-2003     Citation Subset:  IM    
Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France.
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MeSH Terms
Anti-Arrhythmia Agents / therapeutic use
Atrial Fibrillation / pathology,  physiopathology*
Atrial Function*
Body Surface Potential Mapping
Catheter Ablation
Coronary Vessels / pathology,  physiopathology
Endocardium / physiopathology*
Heart Atria / pathology,  physiopathology
Heart Rate
Heart Septum / pathology,  physiopathology
Middle Aged
Vena Cava, Superior / pathology,  physiopathology
Reg. No./Substance:
0/Anti-Arrhythmia Agents

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