13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-77

Is there an anatomically distinct pattern of atrial electrograms in patients with paroxysmal atrial fibrillation? Goette atrial electrograms during atrial fibrillation

Andreas Goette, J. Christoph Geller, Wolfgang M. Hartung, Angelo Auricchio, Hans-Dieter Esperer, Helmut U. Klein.
Department of Internal Medicine, Division of Cardiology, University Hospital Magdeburg, Magdeburg, Germany

Introduction

Four different types of bipolar electrogram patterns have been characterized during atrial fibrillation: type I represents discrete, organized atrial electrograms with intervening isoelectric lines free of perturbation. Type II shows also discrete atrial electrograms but with perturbed isoelectric lines. Type III has disorganized atrial electrograms without clear isoelectric intervals. Type IV is characterized as alternation between types I and III¹. Recent animal studies have tried to characterize the distribution of electrograms during induced episodes of atrial fibrillation^2,3. Li et al³ described that the type of bipolar electrograms (type I, II or III) were specifically distributed in an anatomic pattern throughout the atria in these models. Atrial fibrillation type I was predominantly observed at left atrial sites and the right atrial appendage, whereas type III was predominantly recorded at the right posterolateral atrium. The purpose of this study was to classify the anatomic distribution of the atrial effective refractory period (ERP) in relation to the observed bipolar electrograms during induced atrial fibrillation in patients with and without a history of paroxysmal atrial fibrillation.