1. Direction‐ and rate‐dependent fractionation during atrial fibrillation persistence: Unmasking cardiac anisotropy?
- Author
-
Natasja M.S. de Groot, Roeliene Starreveld, and Cardiology
- Subjects
Special Section: Cast‐af 2019 ,Case Reports ,anisotropy ,030204 cardiovascular system & hematology ,surgical ablation ,03 medical and health sciences ,0302 clinical medicine ,Nuclear magnetic resonance ,Physiology (medical) ,Medicine ,atrial fibrillation ,fractionation ,030212 general & internal medicine ,Rate dependency ,Anisotropy ,Anisotropic conduction ,rate‐dependency ,business.industry ,Rate dependent ,Atrial fibrillation ,Thermal conduction ,medicine.disease ,direction‐dependency ,Cardiology and Cardiovascular Medicine ,business ,Persistence (discontinuity) ,Surgical ablation - Abstract
This human case is the first to illustrate morphological manifestations of direction‐ and rate‐dependent anisotropic conduction in high‐resolution unipolar atrial potentials. Premature impulses induced low‐amplitude, fractionated extracellular potentials with exceptionally prolonged durations in a 76‐year old longstanding persistent patient with atrial fibrillation (AF), demonstrating direction‐dependency of anisotropic conduction. An increased pacing frequency induced presence of similar fractionated potentials, reflecting rate‐dependent anisotropy and inhomogeneous, slow conduction. Pacing with different rates and from different sites could aid in identifying nonuniform anisotropic tissue and thus the substrate of AF.
- Published
- 2020