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 Zrenner, B. Articles by Schmitt, C. Search for Related Content PubMed PubMed Citation Articles by Zrenner, B. Articles by Schmitt, C.

CLINICAL STUDY

Electrophysiologic characteristics of paroxysmal and chronic atrial fibrillation in human right atrium

^a Deutsches Herzzentrum München and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

Manuscript received February 9, 2001; revised manuscript received May 16, 2001, accepted June 19, 2001.

Reprint requests and correspondence: Dr. Bernhard Zrenner, Deutsches Herzzentrum München, Lazarettstrasse 36, D-80636 München, Germany
Zrenner{at}dhm.mhn.de

OBJECTIVES

The aim of the study was to analyze the electrophysiologic characteristics of paroxysmal (PAF) and chronic (CAF) atrial fibrillation (AF) in the human right atrium (RA).

BACKGROUND

Differences that exist between PAF and CAF and the mechanisms of self-sustenance of these arrhythmias are incompletely understood.

METHODS

A total of 53 patients with PAF (25 patients, mean age 59 ± 6.1 years, 3 women) and CAF (28 patients, mean age 59 ± 13 years, 7 women) underwent multisite mapping of the RA during ongoing AF using a 64-electrode basket catheter. Quantitative evaluation and three-dimensional activation patterns were performed using a computerized system.

RESULTS

Patients with PAF, as compared with patients with CAF, had significantly longer AF cycle length, shorter time intervals with type III AF throughout the RA and a smaller number of endocardial breakthroughs (mean 51 ± 19 vs. 104 ± 40, p < 0.001). The majority of endocardial breakthrough points (88% in PAF patients and 98% in CAF patients) were located in the septal region and coincided anatomically with major interatrial connection routes. Coexistence of re-entrant and apparently focal activation determined maintenance of AF in the RA in PAF, whereas random re-entry was documented more frequently in patients with CAF. In patients with CAF, the duration of arrhythmia (in years) correlated strongly with the percentage of time during which type III AF was observed in the lateral wall of the RA (r = 0.71).

CONCLUSIONS

Clinical PAF and CAF, as recorded in the RA, have, at least quantitatively, distinct electrophysiologic features and different mechanisms of maintenance.

Abbreviations and Acronyms   AF = atrial fibrillation   BC = basket catheter   CAF = chronic atrial fibrillation   PAF = paroxysmal atrial fibrillation   RA = right atrium

This article has been cited by other articles:

				J. L. Serra and M. Bendersky Review: Atrial fibrillation and renin-angiotensin system Therapeutic Advances in Cardiovascular Disease, June 1, 2008; 2(3): 215 - 223. [Abstract] [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]