Simultaneous biatrial computerized mapping during permanent atrial fibrillation in patients with organic heart disease

Tsu Juey Wu, Rahul N. Doshi, Hsun Lun A Huang, Carlos Blanche, Robert M. Kass, Alfredo Trento, Wen Cheng, Hrayr S. Karagueuzian, C. Thomas Peter, Peng-Sheng Chen

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Introduction: Activation patterns during permanent atrial fibrillation (AF) in patients with organic heart diseases are unclear. Methods and Results: We studied six patients with permanent AF and organic heart diseases undergoing surgery. The duration of AF averaged 4.9 ± 7.6 years. Computerized epicardial mappings of the right atrial (RA) free wall and the left atrial (LA) posterior wall were simultaneously performed with 224 bipolar electrodes at 3-mm spatial resolution. In the RA, large wavefronts and conduction blocks were frequently observed. The lines of block correlated with the crista terminalis and large pectinate muscles. In contrast, the LA had rapid repetitive activities originated from corners of the electrode plaque, near the four pulmonary veins (PVs). On average, 2.8 ± 1.2 sites of rapid repetitive activities were identified per patient. They activated continuously, intermittently, or alternately during AF. The mean activation cycle length in the RA (196 ± 22 msec) was significantly longer than that in the LA (179 ± 26 msec; P = 0.004). The maximum dominant frequency in the LA was higher than that in the RA (6.41 ± 1.18 Hz vs 5.66 ± 0.55 Hz; P = 0.049). The maximum dominant frequency was consistently located in areas with rapid repetitive activations near the PVs. Conclusion: During human permanent AF associated with organic heart diseases, the activation cycle length was shorter in the LA posterior wall than in the RA free wall. Rapid repetitive activities are consistently observed in the LA posterior wall, at or near the PVs.

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume13
Issue number6
StatePublished - 2002
Externally publishedYes

Fingerprint

Atrial Fibrillation
Heart Diseases
Pulmonary Veins
Electrodes
Epicardial Mapping
Muscles

Keywords

  • Arrhythmia
  • Fibrillation
  • Mapping
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Simultaneous biatrial computerized mapping during permanent atrial fibrillation in patients with organic heart disease. / Wu, Tsu Juey; Doshi, Rahul N.; Huang, Hsun Lun A; Blanche, Carlos; Kass, Robert M.; Trento, Alfredo; Cheng, Wen; Karagueuzian, Hrayr S.; Peter, C. Thomas; Chen, Peng-Sheng.

In: Journal of Cardiovascular Electrophysiology, Vol. 13, No. 6, 2002, p. 571-577.

Research output: Contribution to journalArticle

Wu, TJ, Doshi, RN, Huang, HLA, Blanche, C, Kass, RM, Trento, A, Cheng, W, Karagueuzian, HS, Peter, CT & Chen, P-S 2002, 'Simultaneous biatrial computerized mapping during permanent atrial fibrillation in patients with organic heart disease', Journal of Cardiovascular Electrophysiology, vol. 13, no. 6, pp. 571-577.
Wu, Tsu Juey ; Doshi, Rahul N. ; Huang, Hsun Lun A ; Blanche, Carlos ; Kass, Robert M. ; Trento, Alfredo ; Cheng, Wen ; Karagueuzian, Hrayr S. ; Peter, C. Thomas ; Chen, Peng-Sheng. / Simultaneous biatrial computerized mapping during permanent atrial fibrillation in patients with organic heart disease. In: Journal of Cardiovascular Electrophysiology. 2002 ; Vol. 13, No. 6. pp. 571-577.
@article{608c438bece74371aea54cfcd17dc3d9,
title = "Simultaneous biatrial computerized mapping during permanent atrial fibrillation in patients with organic heart disease",
abstract = "Introduction: Activation patterns during permanent atrial fibrillation (AF) in patients with organic heart diseases are unclear. Methods and Results: We studied six patients with permanent AF and organic heart diseases undergoing surgery. The duration of AF averaged 4.9 ± 7.6 years. Computerized epicardial mappings of the right atrial (RA) free wall and the left atrial (LA) posterior wall were simultaneously performed with 224 bipolar electrodes at 3-mm spatial resolution. In the RA, large wavefronts and conduction blocks were frequently observed. The lines of block correlated with the crista terminalis and large pectinate muscles. In contrast, the LA had rapid repetitive activities originated from corners of the electrode plaque, near the four pulmonary veins (PVs). On average, 2.8 ± 1.2 sites of rapid repetitive activities were identified per patient. They activated continuously, intermittently, or alternately during AF. The mean activation cycle length in the RA (196 ± 22 msec) was significantly longer than that in the LA (179 ± 26 msec; P = 0.004). The maximum dominant frequency in the LA was higher than that in the RA (6.41 ± 1.18 Hz vs 5.66 ± 0.55 Hz; P = 0.049). The maximum dominant frequency was consistently located in areas with rapid repetitive activations near the PVs. Conclusion: During human permanent AF associated with organic heart diseases, the activation cycle length was shorter in the LA posterior wall than in the RA free wall. Rapid repetitive activities are consistently observed in the LA posterior wall, at or near the PVs.",
keywords = "Arrhythmia, Fibrillation, Mapping, Surgery",
author = "Wu, {Tsu Juey} and Doshi, {Rahul N.} and Huang, {Hsun Lun A} and Carlos Blanche and Kass, {Robert M.} and Alfredo Trento and Wen Cheng and Karagueuzian, {Hrayr S.} and Peter, {C. Thomas} and Peng-Sheng Chen",
year = "2002",
language = "English (US)",
volume = "13",
pages = "571--577",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Simultaneous biatrial computerized mapping during permanent atrial fibrillation in patients with organic heart disease

AU - Wu, Tsu Juey

AU - Doshi, Rahul N.

AU - Huang, Hsun Lun A

AU - Blanche, Carlos

AU - Kass, Robert M.

AU - Trento, Alfredo

AU - Cheng, Wen

AU - Karagueuzian, Hrayr S.

AU - Peter, C. Thomas

AU - Chen, Peng-Sheng

PY - 2002

Y1 - 2002

N2 - Introduction: Activation patterns during permanent atrial fibrillation (AF) in patients with organic heart diseases are unclear. Methods and Results: We studied six patients with permanent AF and organic heart diseases undergoing surgery. The duration of AF averaged 4.9 ± 7.6 years. Computerized epicardial mappings of the right atrial (RA) free wall and the left atrial (LA) posterior wall were simultaneously performed with 224 bipolar electrodes at 3-mm spatial resolution. In the RA, large wavefronts and conduction blocks were frequently observed. The lines of block correlated with the crista terminalis and large pectinate muscles. In contrast, the LA had rapid repetitive activities originated from corners of the electrode plaque, near the four pulmonary veins (PVs). On average, 2.8 ± 1.2 sites of rapid repetitive activities were identified per patient. They activated continuously, intermittently, or alternately during AF. The mean activation cycle length in the RA (196 ± 22 msec) was significantly longer than that in the LA (179 ± 26 msec; P = 0.004). The maximum dominant frequency in the LA was higher than that in the RA (6.41 ± 1.18 Hz vs 5.66 ± 0.55 Hz; P = 0.049). The maximum dominant frequency was consistently located in areas with rapid repetitive activations near the PVs. Conclusion: During human permanent AF associated with organic heart diseases, the activation cycle length was shorter in the LA posterior wall than in the RA free wall. Rapid repetitive activities are consistently observed in the LA posterior wall, at or near the PVs.

AB - Introduction: Activation patterns during permanent atrial fibrillation (AF) in patients with organic heart diseases are unclear. Methods and Results: We studied six patients with permanent AF and organic heart diseases undergoing surgery. The duration of AF averaged 4.9 ± 7.6 years. Computerized epicardial mappings of the right atrial (RA) free wall and the left atrial (LA) posterior wall were simultaneously performed with 224 bipolar electrodes at 3-mm spatial resolution. In the RA, large wavefronts and conduction blocks were frequently observed. The lines of block correlated with the crista terminalis and large pectinate muscles. In contrast, the LA had rapid repetitive activities originated from corners of the electrode plaque, near the four pulmonary veins (PVs). On average, 2.8 ± 1.2 sites of rapid repetitive activities were identified per patient. They activated continuously, intermittently, or alternately during AF. The mean activation cycle length in the RA (196 ± 22 msec) was significantly longer than that in the LA (179 ± 26 msec; P = 0.004). The maximum dominant frequency in the LA was higher than that in the RA (6.41 ± 1.18 Hz vs 5.66 ± 0.55 Hz; P = 0.049). The maximum dominant frequency was consistently located in areas with rapid repetitive activations near the PVs. Conclusion: During human permanent AF associated with organic heart diseases, the activation cycle length was shorter in the LA posterior wall than in the RA free wall. Rapid repetitive activities are consistently observed in the LA posterior wall, at or near the PVs.

KW - Arrhythmia

KW - Fibrillation

KW - Mapping

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=0035991579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035991579&partnerID=8YFLogxK

M3 - Article

VL - 13

SP - 571

EP - 577

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 6

ER -