Human atrial fibrillation initiates via organized rather than disorganized mechanisms.

ABSTRACT:

Background

It is unknown how atrial fibrillation (AF) is actually initiated by triggers. Based on consistencies in atrial structure and function in individual patients between episodes of AF, we hypothesized that human AF initiates when triggers interact with deterministic properties of the atria and may engage organized mechanisms.

Methods and results

In 31 patients with AF, we mapped AF initiation after spontaneous triggers or programmed stimulation. We used 64-pole basket catheters to measure regional dynamic conduction slowing and to create biatrial activation maps during transitions to AF. Sixty-two AF initiations were recorded (spontaneous, n=28; induced, n=34). Notably, AF did not initiate by disorganized mechanisms, but by either a dominant reentrant spiral wave (76%

SUBMITTER: Schricker AA 

PROVIDER: S-EPMC4206587 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature