Atrial fibrillation: The mother rotor and its rebellious offspring take turns sustaining the family

Valderrábano, Miguel

doi:10.1016/j.hrthm.2009.04.019

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…Stable rotors have been considered as a mechanism of AF initiation and maintenance anatomically or functionally for the past few decades [ 5 , 6 , 22 – 28 ]. Large amounts of experimental evidence and in-silico validations have supported the role of stable rotors in AF [ 6 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Spatiotemporal Stability of Dominant Frequency Sites in In-Silico Modeling of 3-Dimensional Left Atrial Mapping of Atrial Fibrillation

Lim

Hwang

et al. 2016

PLoS ONE

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BackgroundWe previously reported that stable rotors were observed in in-silico human atrial fibrillation (AF) models, and were well represented by dominant frequency (DF). We explored the spatiotemporal stability of DF sites in 3D-AF models imported from patient CT images of the left atrium (LA).MethodsWe integrated 3-D CT images of the LA obtained from ten patients with persistent AF (male 80%, 61.8 ± 13.5 years old) into an in-silico AF model. After induction, we obtained 6 seconds of AF simulation data for DF analyses in 30 second intervals (T1–T9). The LA was divided into ten sections. Spatiotemporal changes and variations in the temporal consistency of DF were evaluated at each section of the LA. The high DF area was defined as the area with the highest 10% DF.Results1. There was no spatial consistency in the high DF distribution at each LA section during T1–T9 except in one patient (p = 0.027). 2. Coefficients of variation for the high DF area were highly different among the ten LA sections (p < 0.001), and they were significantly higher in the four pulmonary vein (PV) areas, the LA appendage, and the peri-mitral area than in the other LA sections (p < 0.001). 3. When we conducted virtual ablation of 10%, 15%, and 20% of the highest DF areas (n = 270 cases), AF was changed to atrial tachycardia (AT) or terminated at a rate of 40%, 57%, and 76%, respectively.ConclusionsSpatiotemporal consistency of the DF area was observed in 10% of AF patients, and high DF areas were temporally variable. Virtual ablation of DF is moderately effective in AF termination and AF changing into AT.

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Section: Discussionmentioning

confidence: 99%

The Spatiotemporal Stability of Dominant Frequency Sites in In-Silico Modeling of 3-Dimensional Left Atrial Mapping of Atrial Fibrillation

Lim

Hwang

et al. 2016

PLoS ONE

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“…The "multiple wavelet hypothesis" proposes that multiple independent reentrant wavelets exist, perpetuating the arrhythmia. 100,101 Other competing theories include focal activity within the ganglionic plexi (collections of autonomic tissue within the atrium) or untethered macro-reentrant circuits in the form of smaller spiral reentrant drivers, often termed "rotors." 102,103 Likely one of these theories may predominate in a single patient, but all may contribute in some form and fashion in the maintenance in the storm that is AF.…”

Section: Af Pathophysiologymentioning

confidence: 99%

Current Evidence-Based Understanding of the Epidemiology, Prevention, and Treatment of Atrial Fibrillation

Rogers

Bernard

Madias

et al. 2018

Current Problems in Cardiology

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Atrial fibrillation (AF) is the most common atrial arrhythmia in adults worldwide. As medical advancements continue to contribute to an ever-increasing aging population, the burden of atrial fibrillation on the modern health care system continues to increase. Therapies are also evolving, for treatment of the arrhythmia itself, and stroke risk mitigation. Internists and cardiologists alike are, in most instances, the frontline contact for AF patients, and would benefit from remaining facile in their understanding of care options. To continue to deliver high-quality care to this expanding patient group, an updated, concise review for the clinician is prudent. This article provides a comprehensive summary of the current epidemiology and pathophysiology of AF, as well as contemporary procedural therapeutic options.

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“…Among competing theories, the "multiple wavelet hypothesis" proposes that there are multiple independent reentrant wavelets that exist within the fibrillating atria. 104,105 Other theories include focal activity within cardiac ganglionic plexi and untethered macroreentrant activity in the form of small spiral reentrant drivers, often termed rotors. 106 Some consider rotors to be analogous to the vortex of a tornado, giving rise to the surrounding storm of AF.…”

Section: Pathophysiology Of Afmentioning

confidence: 99%

The State of the Art

Morin

Bernard

Madias

et al. 2016

Mayo Clinic Proceedings

160

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As the most common sustained arrhythmia in adults, atrial fibrillation (AF) is an established and growing epidemic. To provide optimal patient care, it is important for clinicians to be aware of AF's epidemiological trends, methods of risk reduction, and the various available treatment modalities. Our understanding of AF's pathophysiology has advanced, and with this new understanding has come advancements in prevention strategies as well as pharmacological and nonpharmacological treatment options. Following PubMed and MEDLINE searches for AF risk factors, epidemiology, and therapies, we reviewed relevant articles (and bibliographies of those articles) published from 2000 to 2016. This "state-of-the-art" review provides a comprehensive update on the understanding of AF in the world today, contemporary therapeutic options, and directions of ongoing and future study.

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Atrial fibrillation: The mother rotor and its rebellious offspring take turns sustaining the family

Cited by 5 publications

References 24 publications

The Spatiotemporal Stability of Dominant Frequency Sites in In-Silico Modeling of 3-Dimensional Left Atrial Mapping of Atrial Fibrillation

The Spatiotemporal Stability of Dominant Frequency Sites in In-Silico Modeling of 3-Dimensional Left Atrial Mapping of Atrial Fibrillation

Current Evidence-Based Understanding of the Epidemiology, Prevention, and Treatment of Atrial Fibrillation

The State of the Art

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