Biatrial multisite mapping of atrial premature complexes triggering onset of atrial fibrillation

Pulmonary veins are considered to be the most common origin of the focal activity that triggers the onset of atrial fibrillation (AF). However, little is known about the importance of ectopic activity located outside the pulmonary veins. This study included 45 patients (8 women and 37 men, mean age...

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Bibliographic Details
Published in:The American journal of cardiology 2002-06, Vol.89 (12), p.1381-1387
Main Authors: Schmitt, Claus, Ndrepepa, Gjin, Weber, Stefan, Schmieder, Sebastian, Weyerbrock, Sonja, Schneider, Michael, Karch, Martin R, Deisenhofer, Isabel, Schreieck, Jürgen, Zrenner, Bernhard, Schömig, Albert
Format: Article
Language:English
Subjects:
Atrial Fibrillation - etiology
Atrial Fibrillation - physiopathology
Atrial Fibrillation - surgery
Atrial Premature Complexes - complications
Atrial Premature Complexes - diagnosis
Atrial Premature Complexes - physiopathology
Biological and medical sciences
Blood vessels
Cardiac arrhythmia
Cardiac Catheterization - methods
Cardiac dysrhythmias
Cardiology
Cardiology. Vascular system
Catheter Ablation
Electrophysiologic Techniques, Cardiac - methods
Female
Heart
Heart Atria - physiopathology
Humans
Imaging, Three-Dimensional
Male
Medical sciences
Middle Aged
Pulmonary Veins
Treatment Outcome
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Summary:Pulmonary veins are considered to be the most common origin of the focal activity that triggers the onset of atrial fibrillation (AF). However, little is known about the importance of ectopic activity located outside the pulmonary veins. This study included 45 patients (8 women and 37 men, mean age 55 ± 12 years) with paroxysmal (n = 25) and persistent (n = 20) AF in whom multisite mapping of the right and left atria was performed using a 64-electrode basket catheter (n = 21) or a noncontact mapping system (n = 24). Spontaneous or orciprenaline-induced atrial premature complexes (APCs) were mapped. In all, 94 AF onsets from 38 distinct foci in 30 patients were observed and analyzed. Of these foci, 20 (53%) were located in pulmonary veins and 18 (47%) were located outside the pulmonary veins in other parts of the atria. In 22 patients (73%), AF was reproducibly induced by APCs from a single focus (59 episodes). In 8 patients (27%), AF originated from 2 distinct foci (35 episodes). Additionally, 20 of 30 patients (67%) who developed AF had APCs in different locations not inducing AF. APCs inducing AF had shorter coupling intervals than APCs not inducing AF (307 ± 54 vs 409 ± 76 ms, p
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(02)02350-0