Riccardo Riccardi, Leonardo Calo,
Marco Scaglione, Filippo Lamberti, Lucia Garberoglio, Paolo Di Donna, Riccardo Massa,
Elena Richiardi, Mario Bocchiardo, Domenico Pecora, Antonello Perucca, Luisella Coda,
Renzo Antolini*, Fiorenzo Gaita.
Department of Cardiology, Ospedale Civile di Asti,
*Department of Physics, University of Trento, Italy
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Atrial fibrillation (AF) is the most frequent
supraventricular arrhythmia but despite this its electrophysiologic substrate is still not
completely known due to few studies on atrial activation during AF in humans. Aim of this
study was to evaluate the spatial and temporal distribution of wavelets circulating
throughout the atrial tissue with an extensive mapping of the electrical excitation of the
atria during AF.
Endocardial mapping of right (RA) and left atrium (LA) during AF was performed in 10
patients (pts) with paroxysmal idiopathic AF. Electrograms were simultaneously recorded in
the RA by a basket catheter and in the LA by 2 decapolar catheters positioned in the
coronary sinus (CS) and on the septum. AF intervals (FF) in a 10 s period and the
morphologic features of AF by Wells' classification for 30 s to quantify the degree of
organization of AF were analyzed simultaneously in 10 atrial sites. In the RA the analyzed
regions were: high (RHL) and low lateral wall (RLL), anterior wall (RA), high (RHP) and
low posterior wall (RLP), high (RHS) and low septum (RLS), and in the LA: high septum
(LHS), low septum (LLS) and the coronary sinus (CS). Different regions of the atria showed
different activation pattern. The LS, LP, LHS and LLS showed significantly shorter FF
intervals than the right lateral wall; similarly in the same regions a higher prevalence
of type I AF was present, although it did not reach a statistical significance.
Atrial mapping during AF in these pts showed a non homogeneous pattern of activation
in different regions of the atria. The septal and right low posterior areas are the
regions with the more irregular and disorganised atrial activity.
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