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https://hdl.handle.net/2440/39230
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Type: | Journal article |
Title: | Sites of focal atrial activity characterized by endocardial mapping during atrial fibrillation |
Author: | Takahashi, Y. Hocini, M. O'Neill, M. Sanders, P. Rotter, M. Rostock, T. Jonsson, A. Sacher, F. Clementy, J. Jais, P. Haissaguerre, M. |
Citation: | Journal of the American College of Cardiology, 2006; 47(10):2005-2012 |
Publisher: | Elsevier Science Inc |
Issue Date: | 2006 |
ISSN: | 0735-1097 1558-3597 |
Statement of Responsibility: | Yoshihide Takahashi, Mélèze Hocini, Mark D. O’Neill, Prashanthan Sanders, Martin Rotter, Thomas Rostock, Anders Jonsson, Frédéric Sacher, Jacques Clémenty, Pierre Jaïs and Michel Haïssaguerre |
Abstract: | <h4>Objectives</h4>The aim of the present study was to assess the feasibility of identifying sites of focal atrial activity by localized high-density endocardial mapping during atrial fibrillation (AF).<h4>Background</h4>Sites of focal activity in the left atrium have been demonstrated by epicardial mapping during AF.<h4>Methods</h4>Twenty-four patients (15 with paroxysmal, 3 with persistent, and 6 with permanent AF) underwent endocardial mapping during AF. A 20-pole catheter with five radiating spines was used to map both atria for 30 s in each of 10 pre-determined segments. A focal activity was defined as > or =3 atrial cycles with activation spreading from center to periphery of the mapping catheter. Catheter ablation was performed independent of the mapping results.<h4>Results</h4>Spontaneous focal activities were observed in 13 sites in the left atrium (9%; anterior 1, roof 2, posterior 6, inferior 4) in 12 patients (9 paroxysmal, 3 persistent). Focal activity was observed continuously (two sites) or intermittently (11 sites, median 5 episodes), and associated with shortening of the cycle length (from 183 +/- 33 ms to 172 +/- 29 ms; p < 0.05). The mean duration of an intermittent episode was 1.5 s (range 0.4 to 7.1 s). Atrial fibrillation terminated without ablation at the foci in all of 12 patients, but in 2 of them, re-initiated arrhythmia was successfully ablated at these foci. Nine of these 12 patients (75%) were arrhythmia-free without antiarrhythmic drugs during a follow-up period of 7.0 +/- 3.1 months.<h4>Conclusions</h4>Termination of AF without ablation at the sites of atrial focal activity suggests that this activity may be triggered by impulses originating from other regions, such as the pulmonary veins. |
Keywords: | Pulmonary Veins Endocardium Heart Atria Humans Atrial Fibrillation Anti-Arrhythmia Agents Electrocardiography Electrophysiologic Techniques, Cardiac Catheter Ablation Follow-Up Studies Feasibility Studies Adult Middle Aged Female Male |
Description: | © 2006 by the American College of Cardiology Foundation. Published by Elsevier Inc. |
DOI: | 10.1016/j.jacc.2005.12.068 |
Published version: | http://dx.doi.org/10.1016/j.jacc.2005.12.068 |
Appears in Collections: | Aurora harvest 6 Medicine publications |
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