Location and coupling interval of an ectopic excitation determine the initiation of atrial fibrillation from the pulmonary veins.

ABSTRACT:

Introduction

Ectopic beats originating from the pulmonary vein (PV) trigger atrial fibrillation (AF). The purpose of this study was to clarify the electrophysiological determinant of AF initiation from the PVs.

Methods

Pacing studies were performed with a single extra stimulus mimicking an ectopic beat in the left superior PVs (LSPVs) in 62 patients undergoing AF ablation. Inducibility of AF, effective refractory period (ERP), and conduction properties within the PVs were analyzed.

Results

A single extra stimulus in LSPV induced AF in 20 patients (32% of all patients) at the mean coupling interval (CI) of 172 ms. A CI-dependent anisotropic conduction at the AF onset was visualized in a three-dimensional mapping. Onset of AF was site-specific with reproducibility in ea

SUBMITTER: Kawai S 

PROVIDER: S-EPMC9303182 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature