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Differences in organization between acute and chronic atrial fibrillation in dogs

Haris J. Sih, PhD^*, Douglas P. Zipes, MD, FACC, Edward J. Berbari, PhD^* , David E. Adams and Jeffrey E. Olgin, MD, FACC

^* Department of Electrical Engineering, Indiana University Purdue University, Indianapolis, Indiana, USA
Krannert Institute of Cardiology, Department of Medicine, Indiana University Purdue University, Indianapolis, Indiana, USA

View larger version (124K): [in a new window]   Figure 1 Four custom-built arrays (240 unipoles) covered the right free wall (RFW), the lateral aspect of the right atrial appendage (RAA), the medial aspect of the RAA, the left free wall (LFW), the lateral aspect of the left atrial appendage (LAA) and the medial aspect of the LAA. BB = Bachmann’s bundle; IVC = inferior vena cava; PV = pulmonary veins; SVC = superior vena cava.

View larger version (13K): [in a new window]   Figure 2 Posterior view of the atria (left) and outline of the mapped regions (right). Numbers indicate the 16 atrial locations from which AF cycle lengths were measured.

View larger version (17K): [in a new window]   Figure 3 Left atrial (LA) and right atrial (RA) cycle lengths during acute or chronic AF. Top panel = mean AF cycle length; bottom panel = minimum AF cycle length. *p < 0.0001. Cycle length decreases in chronic AF, most significantly in the LA. AF = atrial fibrillation.

View larger version (29K): [in a new window]   Figure 4 Comparison of AF cycle lengths for the 16 atrial locations. *p < 0.05. Solid triangles = acute AF; solid circles = chronic AF. Top panel = mean AF cycle length; bottom panel = minimum AF cycle length. Chronic AF cycle lengths are generally shorter, except in or close to the right atrial free wall. AF = atrial fibrillation.

View larger version (28K): [in a new window]   Figure 5 Prediction error/disorganization according to atrial region. Solid triangles = acute AF. Solid circles = chronic AF. AF = atrial fibrillation; FW = atrial free wall; LatAp = lateral atrial appendage; MedAp = medial atrial appendage. *p < 0.05; **p < 0.001.

View larger version (68K): [in a new window]   Figure 6 Example activation map sequences over 400 ms during acute and chronic AF. Regions in gray indicate areas either not activated or a portion of the electrode array not in contact with atrial tissue. In the acute AF group, left atrial activation was dominated by repetitive activation originating from the deep posterior and medial atrium. Activation in the right free wall had two to four wavelets that would have a stable pattern for two to three cycles before changing. In the chronic AF group, activation maps showed more complex activation in the left atrium. The right atrium had three to five wavelets that would also have a stable pattern for two to three cycles before changing.