Mechanisms of wave fractionation at boundaries of high-frequency excitation in the posterior left atrium of the isolated sheep heart during atrial fibrillation

High-frequency fractionated electrograms recorded during atrial fibrillation (AF) in the posterior left atrium (PLA) and elsewhere are being used as target sites for catheter ablation. We tested the hypothesis that highly periodic electric waves emerging from AF sources at or near the PLA give rise...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2006-02, Vol.113 (5), p.626-633
Main Authors: KALIFA, Jérome, TANAKA, Kazuhiko, ATIENZA, Felipe, GUIRAUDON, Gérard, JALIFE, José, BERENFELD, Omer, ZAITSEV, Alexey V, WARREN, Mark, VAIDYANATHAN, Ravi, AUERBACH, David, PANDIT, Sandeep, VIKSTROM, Karen L, PLOUTZ-SNYDER, Robert, TALKACHOU, Arkadzi
Format: Article
Language:English
Subjects:
Animals
Atrial Fibrillation - physiopathology
Biological and medical sciences
Blood and lymphatic vessels
Blood coagulation. Blood cells
Body Surface Potential Mapping
Cardiology. Vascular system
Cardiovascular system
Catheter Ablation
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Electrocardiography - methods
Fourier Analysis
Fundamental and applied biological sciences. Psychology
Heart Atria - physiopathology
Heart Conduction System - physiopathology
In Vitro Techniques
Medical sciences
Miscellaneous
Molecular and cellular biology
Pharmacology. Drug treatments
Platelet
Sheep
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Summary:High-frequency fractionated electrograms recorded during atrial fibrillation (AF) in the posterior left atrium (PLA) and elsewhere are being used as target sites for catheter ablation. We tested the hypothesis that highly periodic electric waves emerging from AF sources at or near the PLA give rise to the most fractionated activity in adjacent locations. Sustained AF was induced in 8 isolated sheep hearts (0.5 micromol/L acetylcholine). Endocardial videoimaging (DI-4-ANEPPS) and electric mapping of the PLA enabled spatial characterization of dominant frequencies (DFs) and a regularity index (ratio of DF to total power). Regularity index showed that fractionation was lowest within the area with the maximal DF (DFmax domain; 0.19+/-0.02) and highest within a band of &3 mm (0.16+/-0.02; P=0.047) at boundaries with lower-frequency domains. The numbers of spatiotemporal periodic episodes (25.9+/-2.3) and rotors per experiment (1.9+/-0.7) were also highest within the DFmax domain. Most commonly, breakthrough waves at the PLA traveled toward the rest of the atria (76.8+/-8.1% outward versus 23.2+/-8.1% inward; P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.105.575340