Transmural Conduction Is the Predominant Mechanism of Breakthrough During Atrial Fibrillation Evidence From Simultaneous Endo-Epicardial High-Density Activation Mapping
Transmural Conduction Is the Predominant Mechanism of Breakthrough During Atrial Fibrillation Evidence From Simultaneous Endo-Epicardial High-Density Activation Mapping
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DOI：
10.1161/circep.113.000342
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发表时间：
2013-04-01
影响因子：
8.4
通讯作者：
Schotten, Ulrich
中科院分区：
文献类型：
--
作者：
Eckstein, Jens;Zeemering, Stef;Schotten, Ulrich
背景-心内膜内电离(EED)导致房颤波的跨室壁传导(突破)被认为是导致房颤(AF)的基础的复杂性的原因之一。本研究的目的是阐明EED与突破性事件发生率的相关性，并检验跨壁传导和异位局灶性放电作为突破源的可能性。方法和结果-我们分析了急性房颤、房颤3周和6个月的山羊左心房游离壁的高分辨率同步心内膜标测数据(均为7例)。对波的数量、大小和宽度进行分析，并根据其起源在标测区域外(周边波)或在标测区域内(突破)进行分类。房颤急性期突破发生率最低(2.1+/-1.0%)，3周后突破发生率较高(11.4+/-6.1%)(P
Background-Endo-epicardial dissociation (EED) of electric activations resulting in transmural conduction of fibrillation waves (breakthroughs) has been postulated to contribute to the complexity of the substrate of atrial fibrillation (AF). The aim of this study was to elucidate the correlation between EED and incidence of breakthrough and to test the plausibility of transmural conduction versus ectopic focal discharges as sources of breakthrough.Methods and Results-We analyzed high-resolution simultaneous endo-epicardial in vivo mapping data recorded in left atrial free walls of goats with acute AF, 3 weeks and 6 months of AF (all n=7). Waves were analyzed for number, size, and width and categorized according to their origin outside (peripheral wave) or within the mapping area (breakthrough). Breakthrough incidence was lowest (2.1 +/- 1.0%) in acute AF, higher (11.4 +/- 6.1%) after 3 weeks (P