Document Detail

Rotor meandering contributes to irregularity in electrograms during atrial fibrillation.
MedLine Citation:
PMID:  18534369     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Radiofrequency ablation therapy of atrial fibrillation (AF) recently incorporated the analysis of dominant frequency (DF) and/or electrogram fractionation for guidance. However, the relationships between DF, fractionation, and spatiotemporal characteristics of the AF source remain unclear.
OBJECTIVE: We hypothesize that a meandering reentrant AF source contributes to the wave fractionation and is reflected in the power spectrum of local electrograms elsewhere in the rotor's surroundings.
METHODS: Meandering rotors as AF sources were simulated in 2-dimensional models of human atrial tissue and recorded in isolated sheep hearts. Nondominant elements of the signals were differentiated from the dominant elements using singular value decomposition, whereby the purely periodic constituent (PC) relating to the rotor's DF was eliminated rendering a residual constituent (RC) that consisted of all other activity.
RESULTS: Spectral analysis of the decomposed constituents revealed peaks corresponding to the meandering frequency of the rotor tip, the magnitudes of which were proportional to the size of and the distance to the rotor core. Similar analyses on epicardial optical signals and electrograms from isolated sheep hearts, as well as human complex fractionated atrial electrograms, showed applicability of the approach.
CONCLUSION: Increased meandering of the rotor driving AF reduces activation periodicity and increases fractionation. The spectral manifestation of the rotor activity beyond the meandering region makes it possible to characterize AF source stability, as well as DF in humans using electrode mapping.
Sharon Zlochiver; Masatoshi Yamazaki; Jérôme Kalifa; Omer Berenfeld
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-03-14
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  5     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-06     Completed Date:  2008-11-18     Revised Date:  2014-09-19    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  846-54     Citation Subset:  IM    
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MeSH Terms
Atrial Fibrillation / etiology,  physiopathology*,  therapy
Electrocardiography / methods*
Electrophysiologic Techniques, Cardiac* / methods
Heart Atria / innervation,  physiopathology
Heart Conduction System / physiopathology*
Models, Animal
Models, Theoretical
Risk Factors
Grant Support
P01 HL039707-17/HL/NHLBI NIH HHS; P01-HL039707/HL/NHLBI NIH HHS; P01-HL087226/HL/NHLBI NIH HHS; R01 HL087055/HL/NHLBI NIH HHS; R01 HL087055-05/HL/NHLBI NIH HHS; R01-087055-01//PHS HHS; R01-HL070074-05A1/HL/NHLBI NIH HHS

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