Transmural Conduction Is the Predominant Mechanism of Breakthrough During Atrial Fibrillation Evidence From Simultaneous Endo-Epicardial High-Density Activation Mapping

Jens Eckstein; Stef Zeemering; Dominik Linz; Bart Maesen; Sander Verheule; Arne van Hunnik; Harry Crijns; Maurits A. Allessie; Ulrich Schotten

doi:10.1161/CIRCEP.113.000342

Transmural Conduction Is the Predominant Mechanism of Breakthrough During Atrial Fibrillation Evidence From Simultaneous Endo-Epicardial High-Density Activation Mapping

Jens Eckstein, Stef Zeemering, Dominik Linz, Bart Maesen, Sander Verheule, Arne van Hunnik, Harry Crijns, Maurits A. Allessie, Ulrich Schotten^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background-Endo-epicardial dissociation (EED) of electric activations resulting in transmural conduction of fibrillation waves (breakthroughs) has been postulated to contribute to the complexity of the substrate of atrial fibrillation (AF). The aim of this study was to elucidate the correlation between EED and incidence of breakthrough and to test the plausibility of transmural conduction versus ectopic focal discharges as sources of breakthrough. Methods and Results-We analyzed high-resolution simultaneous endo-epicardial in vivo mapping data recorded in left atrial free walls of goats with acute AF, 3 weeks and 6 months of AF (all n=7). Waves were analyzed for number, size, and width and categorized according to their origin outside (peripheral wave) or within the mapping area (breakthrough). Breakthrough incidence was lowest (2.1 +/- 1.0%) in acute AF, higher (11.4 +/- 6.1%) after 3 weeks (P

Original language	English
Pages (from-to)	334-341
Journal	Circulation-Arrhythmia and Electrophysiology
Volume	6
Issue number	2
DOIs	https://doi.org/10.1161/CIRCEP.113.000342
Publication status	Published - Apr 2013

Keywords

arrhythmia
atrial fibrillation
breakthrough
electrophysiology
mapping

Access to Document

10.1161/CIRCEP.113.000342

Cite this

Eckstein, J., Zeemering, S., Linz, D., Maesen, B., Verheule, S., van Hunnik, A., Crijns, H., Allessie, M. A., & Schotten, U. (2013). Transmural Conduction Is the Predominant Mechanism of Breakthrough During Atrial Fibrillation Evidence From Simultaneous Endo-Epicardial High-Density Activation Mapping. Circulation-Arrhythmia and Electrophysiology, 6(2), 334-341. https://doi.org/10.1161/CIRCEP.113.000342

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title = "Transmural Conduction Is the Predominant Mechanism of Breakthrough During Atrial Fibrillation Evidence From Simultaneous Endo-Epicardial High-Density Activation Mapping",

abstract = "Background-Endo-epicardial dissociation (EED) of electric activations resulting in transmural conduction of fibrillation waves (breakthroughs) has been postulated to contribute to the complexity of the substrate of atrial fibrillation (AF). The aim of this study was to elucidate the correlation between EED and incidence of breakthrough and to test the plausibility of transmural conduction versus ectopic focal discharges as sources of breakthrough. Methods and Results-We analyzed high-resolution simultaneous endo-epicardial in vivo mapping data recorded in left atrial free walls of goats with acute AF, 3 weeks and 6 months of AF (all n=7). Waves were analyzed for number, size, and width and categorized according to their origin outside (peripheral wave) or within the mapping area (breakthrough). Breakthrough incidence was lowest (2.1 +/- 1.0%) in acute AF, higher (11.4 +/- 6.1%) after 3 weeks (P",

keywords = "arrhythmia, atrial fibrillation, breakthrough, electrophysiology, mapping",

author = "Jens Eckstein and Stef Zeemering and Dominik Linz and Bart Maesen and Sander Verheule and {van Hunnik}, Arne and Harry Crijns and Allessie, {Maurits A.} and Ulrich Schotten",

year = "2013",

month = apr,

doi = "10.1161/CIRCEP.113.000342",

language = "English",

volume = "6",

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journal = "Circulation-Arrhythmia and Electrophysiology",

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Eckstein, J, Zeemering, S , Linz, D , Maesen, B , Verheule, S , van Hunnik, A , Crijns, H, Allessie, MA & Schotten, U 2013, 'Transmural Conduction Is the Predominant Mechanism of Breakthrough During Atrial Fibrillation Evidence From Simultaneous Endo-Epicardial High-Density Activation Mapping', Circulation-Arrhythmia and Electrophysiology, vol. 6, no. 2, pp. 334-341. https://doi.org/10.1161/CIRCEP.113.000342

Transmural Conduction Is the Predominant Mechanism of Breakthrough During Atrial Fibrillation Evidence From Simultaneous Endo-Epicardial High-Density Activation Mapping. / Eckstein, Jens; Zeemering, Stef ; Linz, Dominik et al.
In: Circulation-Arrhythmia and Electrophysiology, Vol. 6, No. 2, 04.2013, p. 334-341.

Research output: Contribution to journal › Article › Academic › peer-review

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AU - Linz, Dominik

AU - Maesen, Bart

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AU - van Hunnik, Arne

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AU - Schotten, Ulrich

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