1. Incidence, prevalence, and trajectories of repetitive conduction patterns in human atrial fibrillation
- Author
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Jos G. Maessen, Tammo Delhaas, Stef Zeemering, Elham Bidar, Sander Verheule, Frank van Rosmalen, Bart Maesen, Jan Nijs, Pietro Bonizzi, Ben J. M. Hermans, Ulrich Schotten, Arne van Hunnik, Biomedische Technologie, RS: Carim - H01 Clinical atrial fibrillation, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - H08 Experimental atrial fibrillation, Fysiologie, RS: Carim - Heart, Dept. of Advanced Computing Sciences, RS: FSE DACS, RS: FSE DACS Mathematics Centre Maastricht, RS: Carim - V04 Surgical intervention, CTC, MUMC+: MA Cardiothoracale Chirurgie (3), and RS: Carim - H07 Cardiovascular System Dynamics
- Subjects
MECHANISM ,medicine.medical_specialty ,medicine.medical_treatment ,Anatomical structures ,ROTORS ,030204 cardiovascular system & hematology ,Preferential conduction ,03 medical and health sciences ,PERSISTENT ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,Prevalence ,medicine ,ABLATION ,Humans ,030212 general & internal medicine ,PULMONARY VEIN ISOLATION ,Paroxysmal AF ,CATHETER ABLATION ,Atrium (architecture) ,business.industry ,Incidence ,FOCAL IMPULSE ,Atrial fibrillation ,atrial mapping ,Ablation ,medicine.disease ,Repetitive patterns ,Peripheral ,Conduction patterns ,Cardiology ,Electrophysiologic Techniques, Cardiac ,Cardiology and Cardiovascular Medicine ,business ,High-density epicardial ,Incidence prevalence - Abstract
Aims Repetitive conduction patterns in atrial fibrillation (AF) may reflect anatomical structures harbouring preferential conduction paths and indicate the presence of stationary sources for AF. Recently, we demonstrated a novel technique to detect repetitive patterns in high-density contact mapping of AF. As a first step towards repetitive pattern mapping to guide AF ablation, we determined the incidence, prevalence, and trajectories of repetitive conduction patterns in epicardial contact mapping of paroxysmal and persistent AF patients. Methods and results A 256-channel mapping array was used to record epicardial left and right AF electrograms in persistent AF (persAF, n = 9) and paroxysmal AF (pAF, n = 11) patients. Intervals containing repetitive conduction patterns were detected using recurrence plots. Activation movies, preferential conduction direction, and average activation sequence were used to characterize and classify conduction patterns. Repetitive patterns were identified in 33/40 recordings. Repetitive patterns were more prevalent in pAF compared with persAF [pAF: median 59%, inter-quartile range (41–72) vs. persAF: 39% (0–51), P Conclusion High-density epicardial contact mapping in AF patients reveals frequent repetitive conduction patterns. In persistent AF patients, repetitive patterns were less frequent, smaller, and more variable than in paroxysmal AF patients. Future research should elucidate whether these patterns can help in finding AF ablation targets.
- Published
- 2021
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