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Spatially Conserved Spiral Wave Activity During Human Atrial Fibrillation.
Rappel, Wouter-Jan; Baykaner, Tina; Zaman, Junaid; Ganesan, Prasanth; Rogers, Albert J; Narayan, Sanjiv M.
Afiliación
  • Rappel WJ; Department of Physics, University of California, San Diego (W.-J.R.).
  • Baykaner T; Department of Medicine, Stanford University, Palo Alto (T.B., P.G., A.J.R., S.M.N.).
  • Zaman J; Department of Cardiovascular Medicine, University of Southern California, Los Angeles (J.Z.).
  • Ganesan P; Department of Medicine, Stanford University, Palo Alto (T.B., P.G., A.J.R., S.M.N.).
  • Rogers AJ; Department of Medicine, Stanford University, Palo Alto (T.B., P.G., A.J.R., S.M.N.).
  • Narayan SM; Department of Medicine, Stanford University, Palo Alto (T.B., P.G., A.J.R., S.M.N.).
Circ Arrhythm Electrophysiol ; 17(3): e012041, 2024 03.
Article en En | MEDLINE | ID: mdl-38348685
ABSTRACT

BACKGROUND:

Atrial fibrillation is the most common cardiac arrhythmia in the world and increases the risk for stroke and morbidity. During atrial fibrillation, the electric activation fronts are no longer coherently propagating through the tissue and, instead, show rotational activity, consistent with spiral wave activation, focal activity, collision, or partial versions of these spatial patterns. An unexplained phenomenon is that although simulations of cardiac models abundantly demonstrate spiral waves, clinical recordings often show only intermittent spiral wave activity.

METHODS:

In silico data were generated using simulations in which spiral waves were continuously created and annihilated and in simulations in which a spiral wave was intermittently trapped at a heterogeneity. Clinically, spatio-temporal activation maps were constructed using 60 s recordings from a 64 electrode catheter within the atrium of N=34 patients (n=24 persistent atrial fibrillation). The location of clockwise and counterclockwise rotating spiral waves was quantified and all intervals during which these spiral waves were present were determined. For each interval, the angle of rotation as a function of time was computed and used to determine whether the spiral wave returned in step or changed phase at the start of each interval.

RESULTS:

In both simulations, spiral waves did not come back in phase and were out of step." In contrast, spiral waves returned in step in the majority (68%; P=0.05) of patients. Thus, the intermittently observed rotational activity in these patients is due to a temporally and spatially conserved spiral wave and not due to ones that are newly created at the onset of each interval.

CONCLUSIONS:

Intermittency of spiral wave activity represents conserved spiral wave activity of long, but interrupted duration or transient spiral activity, in the majority of patients. This finding could have important ramifications for identifying clinically important forms of atrial fibrillation and in guiding treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos