Paradigm shifts in electrophysiological mechanisms of atrial fibrillation

Ulrich Schotten*, Seungyup Lee, Stef Zeemering, Albert L. Waldo

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Determining the sequence of activation is a major source of information for understanding the electrophysiological mechanism(s) of atrial fibrillation (AF). However, the complex morphology of the electrograms hampers their analysis, and has stimulated generations of electrophysiologists to develop a large variety of technologies for recording, pre-processing, and analysis of fibrillation electrograms. This variability of approaches is mirrored by a large variability in the interpretation of fibrillation electrograms and, thereby, opinions regarding the basic electrophysiological mechanism(s) of AF vary widely. Multiple wavelets, different types of re-entry including rotors, double layers, multiple focal activation patterns all have been advocated, and a comprehensive and commonly accepted paradigm for the fundamental mechanisms of AF is still lacking. Here, we summarize the Maastricht perspective and Cleveland perspective regarding AF mechanism(s). We also describe some of the key observations in mapping of AF reported over the past decades, and how they changed over the years, often as results of new techniques introduced in the experimental field of AF research.

Original languageEnglish
Pages (from-to)9-13
Number of pages5
JournalEP Europace
Volume23
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Atrial fibrilation
  • Elecrophysiology
  • Arrhythmia
  • Heart
  • Mechanisms
  • MULTIPLE WAVELET HYPOTHESIS
  • FOCAL IMPULSE
  • LOCALIZED SOURCES
  • CONVENTIONAL ABLATION
  • PERSISTENT
  • ACTIVATION
  • DENSITY
  • ROTORS
  • CONDUCTION
  • SITES

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