Characteristics of Rapid Rhythms Recorded Within Pulmonary Veins During Atrial Fibrillation

Tada, Hiroshi; Özaydın, Mehmet; Oral, Hakan; Knight, Bradley P.; Chugh, Aman; Scharf, Christoph; Pelosi, Frank; Strickberger, S. Adam; Morady, Fred

doi:10.1046/j.1460-9592.2003.t01-1-00192.x

Cited by 22 publications

(20 citation statements)

References 17 publications

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“…A recent study by Kalifa and colleagues 18 also described evidence of sustained reentry at the LA-PV junction in the sheep model during periods of increased intra-atrial pressure. Although Tada and colleagues 8 found evidence of repetitive firing from the PVs during ongoing AF, Ndrepepa and colleagues, 19 using basket mapping of the LA, found that the posterior LA, not the PVs, was the driver of AF in these patients.…”

Section: Discussionmentioning

confidence: 92%

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Presence of Left-to-Right Atrial Frequency Gradient in Paroxysmal but Not Persistent Atrial Fibrillation in Humans

et al. 2004

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Background— Recent studies have demonstrated spatiotemporal organization in atrial fibrillation (AF), with a left-to-right atrial frequency gradient during AF in isolated sheep hearts. We hypothesized that human AF would also manifest a left-to-right atrial frequency gradient. Methods and Results— Thirty-one patients aged 56.7±10.5 years with a history of paroxysmal or persistent (>1 month) AF were included. Recordings were made at each pulmonary vein (PV) ostium and simultaneously from the coronary sinus (CS) and posterior right atrium (RA) during AF. Sequential fast Fourier transforms (FFTs) were performed. FFT profiles were analyzed to determine the dominant frequency (DF). There were 18 patients with paroxysmal AF and 13 with persistent AF. In the paroxysmal group, there was a significant left-to-right atrial DF gradient, with DF highest at the PV/left atrial (LA) junction, intermediate at the CS, and lowest in the RA (6.2±0.8, 5.5±0.7, and 5.1±0.6 Hz, respectively; P <0.001). There were no patients in whom DF was greater at the RA than the PV/LA junction. In the persistent group, there was no significant difference between DF recorded from the LA/PV junction, CS, and RA (6.1±0.7, 5.8±0.6, and 5.8±0.6 Hz, respectively; P =NS). Conclusions— In humans with paroxysmal AF, DFs are highest at the PV/LA junction, intermediate in the CS, and slowest in the posterior RA. These findings agree with animal models that suggest that the posterior LA may play an important role in maintaining paroxysmal AF. The role of the posterior LA in persistent AF requires further study.

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Section: Discussionmentioning

confidence: 92%

“…Others have reported focal firing within the PVs during sustained AF. 8 However, the role of the left atrium (LA) and PVs in the maintenance of sustained AF in humans is still emerging.…”

mentioning

confidence: 99%

Presence of Left-to-Right Atrial Frequency Gradient in Paroxysmal but Not Persistent Atrial Fibrillation in Humans

et al. 2004

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“…Although persistent, rapidly firing foci from the pulmonary veins have been demonstrated to be present during AF [45] more recent studies have found conclusive evidence that drivers of AF behave like reentrant circuits rather than as foci at least in paroxysmal cases [46]. …”

Section: Implications Of Df Analysis In Afmentioning

confidence: 99%

Frequency Domain Mapping of Atrial Fibrillation - Methodology, Experimental Data and Clinical Implications

Traykov

Pap²,

Sághy³

2012

CCR

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The concept of dominant frequency (DF) has been used as a way to express local atrial activation rate during atrial fibrillation (AF). The rotor theory explaining the pathophysiology of AF is widely based upon spatial distribution of DF in the atria. Using frequency domain analysis to represent the rate of atrial activation by DF can avoid some of the limitations of time domain analysis of signals during AF. Understanding the concept of DF is of utmost importance to the proper use and interpretation of frequency domain analysis in AF. The current review focuses on the basic principles and methodology of frequency domain analysis using the Fourier transform during different types of AF. It also provides an update of the published experimental and clinical data on frequency domain analysis in light of the rotor theory for AF maintenance.

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“…An arrhythmogenic PV was defined as a PV in which a PAC triggering AF was identified during SR 11,12 and/or as a PV demonstrating PV tachycardia during AF. 22 Segmental isolation was attempted in each of the 3 patients as previously described. [10][11][12][13][14][15][16] A 7Fr decapolar ring catheter (Lasso, Biosense Webster, Diamond Bar, CA, USA) and a 7Fr quadripolar ablation catheter with a 4-mm distal electrode, embedded thermistor, 2-5-2 mm inter-electrode spacing, and a deflectable tip (Biosense Webster) were inserted into the left atrium.…”

Section: Electrophysiologic Study and Rcamentioning

confidence: 99%

Percutaneous Transvenous Mitral Commissurotomy and Radiofrequency Catheter Ablation in Patients With Mitral Stenosis Initial Experience and Results

Miyaji

Tada

Ito

et al. 2005

Circ J

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Background The purpose of this study was to evaluate the short-and long-term results of radiofrequency catheter ablation (RFCA) for the treatment of atrial fibrillation (AF) in patients with mitral stenosis (MS) following percutaneous transvenous mitral commissurotomy (PTMC). Methods and ResultsFour patients (2 males, age 59±6 years) underwent simultaneous PTMC and pulmonary vein (PV) ablation. All patient had AF and MS (2 had persistent AF >1 month, 2 had paroxysmal AF), and the mean duration of AF was 3.4±3.3 years. The mean left atrial dimension was 47±7 mm and the mean ejection fraction was 58±4%. After PTMC, RFCA was performed in all patients (3 underwent PV isolation and 1 had PV focal ablation). The mitral valve area increased from 1.11±0.19 to 1.90±0.20 cm 2 (p<0.01). The frequency of AF episodes was dramatically reduced in the 2 patients with paroxysmal AF, and the 1 with persistent AF maintained sinus rhythm, but 1 patient with persistent AF developed recurrent AF. No complications or cardiac events occurred in any of the patients. Conclusion The combination of RFCA and PTMC was safe and feasible, and may be useful in patients with MS and AF. (Circ J 2005; 69: 1074 -1078

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Characteristics of Rapid Rhythms Recorded Within Pulmonary Veins During Atrial Fibrillation

Cited by 22 publications

References 17 publications

Presence of Left-to-Right Atrial Frequency Gradient in Paroxysmal but Not Persistent Atrial Fibrillation in Humans

Presence of Left-to-Right Atrial Frequency Gradient in Paroxysmal but Not Persistent Atrial Fibrillation in Humans

Frequency Domain Mapping of Atrial Fibrillation - Methodology, Experimental Data and Clinical Implications

Percutaneous Transvenous Mitral Commissurotomy and Radiofrequency Catheter Ablation in Patients With Mitral Stenosis Initial Experience and Results

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