Document Detail


A technique for measurement of the extent of spatial organization of atrial activation during atrial fibrillation in the intact human heart.
MedLine Citation:
PMID:  7790014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atrial fibrillation (AF) is a common clinical problem, associated with considerable morbidity and mortality, for which effective management strategies have yet to be devised. The absence of objective measures to guide selection of antiarrhythmic drug therapy for maintenance of sinus rhythm leaves only clinical endpoints (either beneficial or detrimental) for assessment of drug action, with occasional catastrophic consequences. As part of an attempt to provide an objective framework for the assessment of antiarrhythmic drug action on the electrophysiologic determinants of atrial fibrillation, we have developed a measure of the spatial organization of atrial activation processes during atrial fibrillation. By recording activation sequences at multiple equally spaced locations on the endocardial surface of the atria during atrial fibrillation in humans and determining the degree of correlation between these activation sequences as a function of distance, we have been able to construct spatial correlation functions for atrial activation. We have found that atrial activation remains well-correlated, independent of distance during normal sinus rhythm and atrial flutter. During atrial fibrillation, correlation decays monotonically with distance and the space-constant for this decay may be used to describe the relative spatial organization of atrial fibrillation. We provide examples of the impact of antiarrhythmic agents on the space-constant and suggest that assessment of the relative spatial organization of atrial activation using this methodology may potentially provide an objective framework to guide therapy in patients with AF.
Authors:
G W Botteron; J M Smith
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  IEEE transactions on bio-medical engineering     Volume:  42     ISSN:  0018-9294     ISO Abbreviation:  IEEE Trans Biomed Eng     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-07-26     Completed Date:  1995-07-26     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0012737     Medline TA:  IEEE Trans Biomed Eng     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  579-86     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage
Atrial Fibrillation / drug therapy,  physiopathology*
Atrial Flutter / drug therapy,  physiopathology
Electrocardiography / instrumentation,  methods
Electrophysiology
Heart / drug effects,  physiopathology*
Heart Atria / drug effects,  physiopathology
Heart Catheterization
Humans
Mathematics
Procainamide / administration & dosage
Reproducibility of Results
Signal Processing, Computer-Assisted / instrumentation
Grant Support
ID/Acronym/Agency:
R01 HL 50295-01/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
51-06-9/Procainamide; 58-61-7/Adenosine

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


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