This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gaita, F. Articles by Trevi, G. Search for Related Content PubMed PubMed Citation Articles by Gaita, F. Articles by Trevi, G.

CLINICAL STUDY: ELECTROPHYSIOLOGY

Different patterns of atrial activation in idiopathic atrial fibrillation: simultaneous multisite atrial mapping in patients with paroxysmal and chronic atrial fibrillation

Fiorenzo Gaita, MD^*, Leonardo Calò, MD^*, Riccardo Riccardi, MD^*, Lucia Garberoglio, MD^*, Marco Scaglione, MD^*, Giovanni Licciardello, MD^*, Luisella Coda, MD^*, Paolo Di Donna, MD^*, Mario Bocchiardo, MD^*, Domenico Caponi, MD^*, Renzo Antolini, PhD, Fulvio Orzan, MD and GianPaolo Trevi, MD

^* Division of Cardiology, Civil Hospital, Asti, Italy
INFM Department of Physics, University of Trento, Trento, Italy
Department of Internal Medicine/Cardiology, University of Torino, Torino, Italy

Manuscript received February 22, 2000; revised manuscript received August 17, 2000, accepted October 4, 2000.

Reprint requests and correspondence: Dr. Fiorenzo Gaita, Division of Cardiology, Civil Hospital, Via Botallo 4, 14100 Asti, Italy
cardclin{at}provincia.asti.it

OBJECTIVES

We aimed to evaluate: 1) the behavior of electrical activity simultaneously in different atrial regions during atrial fibrillation (AF); 2) the difference of atrial activation between paroxysmal and chronic AF; 3) the atrial refractoriness dispersion; and 4) the correlation between the effective refractory periods (ERPs) and the FF intervals.

BACKGROUND

Little data exist on the electrophysiologic characteristics of the different atrial regions in patients with AF. A more detailed knowledge of the electrical activity during AF may provide further insights to improve treatment of AF.

METHODS

Right and left atria were extensively mapped in 30 patients with idiopathic AF (18 paroxysmal and 12 chronic). In different atrial locations, we analyzed 1) the FF interval duration; and 2) the grade of organization and, in case of organized electrical activity, the direction of atrial activation. Furthermore, in patients with paroxysmal AF, we determined the atrial ERP, evaluated the ERP dispersion and assessed the presence of a correlation between the ERPs and the FF intervals.

RESULTS

In patients with chronic AF, we observed a shortening of the FF intervals and a greater prevalence of disorganized activity in all the atrial sites examined. In patients with paroxysmal AF, a significant dispersion of refractoriness was observed. The right lateral wall showed longer FF intervals and more organized atrial activity and, unexpectedly, the shortest mean ERPs. In contrast, the septal area showed shorter FF intervals, greater disorganization and the longest mean ERPs.

CONCLUSIONS

Electrical activity during AF showed a significant spatial inhomogeneity, which was more evident in patients with paroxysmal AF. The mean FF intervals did not correlate with the mean ERPs.

Abbreviations and Acronyms   AF = atrial fibrillation   CS = coronary sinus   ERP = effective refractory period   LHS = left high septum   LLS = left low septum   LS = left septum   RA = right anterior (wall)   RHL = right high lateral (wall)   RL = right lateral (wall)   RLL = right low lateral (wall)   RP = right posterior (wall)   RS = right septum

This article has been cited by other articles:

				L. Calo, F. Lamberti, M. L. Loricchio, E. De Ruvo, F. Colivicchi, L. Bianconi, C. Pandozi, and M. Santini Left Atrial Ablation Versus Biatrial Ablation for Persistent and Permanent Atrial Fibrillation: A Prospective and Randomized Study J. Am. Coll. Cardiol., June 20, 2006; 47(12): 2504 - 2512. [Abstract] [Full Text] [PDF]

				M. Hocini, P. Sanders, P. Jais, L.-F. Hsu, R. Weerasoriya, C. Scavee, Y. Takahashi, M. Rotter, F. Raybaud, L. Macle, et al. Prevalence of pulmonary vein disconnection after anatomical ablation for atrial fibrillation: consequences of wide atrial encircling of the pulmonary veins Eur. Heart J., April 1, 2005; 26(7): 696 - 704. [Abstract] [Full Text] [PDF]

				T. H. Everett IV, J. G. Akar, L.-C. Kok, J. R. Moorman, and D. E. Haines Use of global atrial fibrillation organization to optimize the success of burst pace termination J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1831 - 1840. [Abstract] [Full Text] [PDF]

				F. Gaita and R. Riccardi Lone atrial fibrillation ablation: Transcatheter or minimally invasive surgical approaches? J. Am. Coll. Cardiol., August 7, 2002; 40(3): 481 - 483. [Full Text] [PDF]

				A. Shimizu and O. A. Centurion Electrophysiological properties of the human atrium in atrial fibrillation Cardiovasc Res, May 1, 2002; 54(2): 302 - 314. [Abstract] [Full Text] [PDF]

				M. Disertori, L. Padeletti, M. Santini, P. Dini, M. Gasparini, G. Inama, M. Botto, G. Boriani, A. Capucci, R. Ricci, et al. Antitachycardia pacing therapies to terminate atrial tachyarrhythmias: the AT500 Italian Registry Eur. Heart J. Suppl., November 1, 2001; 3(suppl_P): P16 - P24. [Abstract] [PDF]