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Are drivers recurring or ephemeral? observations from serial mapping of persistent atrial fibrillation.
Europace
November 2024
Department of Biomedical Engineering, 36 S. Wasatch Drive, SMBB 3100, University of Utah, Salt Lake City, UT 84112, USA.
Aims: Rotational re-entries and ectopic foci, or 'drivers', are proposed mechanisms for persistent atrial fibrillation (persAF), but driver-based interventions have had mixed success in clinical trials. Selective targeting of drivers with multi-month stability may improve these interventions, but no prior work has investigated whether drivers can be stable on such a long timescale.
Objective: We hypothesized that drivers could recur even several months after initial observation.
Catheter ablation for atrial fibrillation: indications and future perspective.
Eur Heart J
November 2024
Haut-Lévèque Cardiology Hospital, Bordeaux, France.
Article Synopsis
- * The main goal of these interventions is to restore stable sinus rhythm, improving quality of life and reducing AF-related risks, with pulmonary vein isolation (PVI) being the primary method for newly diagnosed paroxysmal AF.
- * There are ongoing developments in additional ablation strategies and technologies to better manage AF, especially for non-paroxysmal cases, while also addressing challenges like late relapse and non-PV triggers.
Mapping Atrial Fibrillation Drivers.
Rev Cardiovasc Med
January 2024
The Department of Cardiovascular Medicine, Shin-Yurigaoka General Hospital, 215-0026 Kawasaki, Japan.
Understanding the initiating role of pulmonary veins in atrial fibrillation (AF) has led to the development of pulmonary vein isolation (PVI). The efficacy of PVI is high for paroxysmal AF, whereas it is limited for non-paroxysmal AF. This fact highlights the necessity of understanding the mechanism through which AF is maintained, to develop ablation strategies that would be required in addition to the PVI.
View Article and Find Full Text PDFPulmonary Veins Function as Echo Chambers in Persistent Atrial Fibrillation: Circuitous Re-Entry Generates Outgoing Wavefronts.
JACC Clin Electrophysiol
July 2024
Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia; Baker IDI Heart & Diabetes Institute, Melbourne, Australia. Electronic address:
Background: Although the substrate in persistent atrial fibrillation (PeAF) is not limited to the pulmonary veins (PVs), PV isolation (PVI) remains the cornerstone ablation strategy.
Objectives: The aim of this study was to describe the mechanism of outgoing wavefronts (WFs) originating in the PV sleeves during PeAF.
Methods: Eleven patients presenting for first-time PeAF ablation were recruited (mean age 63.
Atrial fibrillation activation patterns predict freedom from arrhythmias after catheter ablation: utility of ExTRa mapping™.
Front Cardiovasc Med
July 2023
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Article Synopsis
- This study explores the complex mechanisms of atrial fibrillation (AF) and how different activation patterns can impact outcomes after treatment.
- Researchers examined 55 AF patients before ablation, focusing on the nonpassively activated ratio of various atrial segments to understand recurrence risk.
- Results show that specific activation patterns, especially in the left atrium, were significant predictors of whether patients would experience recurrent AF after ablation, suggesting mapping may help guide treatment decisions.
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