From the Departments of Pharmacology (A.C.S., R.M., O.B., J.M.D., J.J.)
and Pediatrics (Cardiology) (R.M.), SUNY Health Science Center at Syracuse,
Syracuse, NY.
Correspondence to Dr J. Jalife, MD, Department of Pharmacology, SUNY Health Science Center, Irving Ave, Syracuse, NY. E-mail jalife{at}vax.cs.hscsyr.edu
Background—The activation patterns
that underlie the irregular electrical activity during atrial
fibrillation (AF) have traditionally been described as disorganized or
random. Recent studies, based predominantly on statistical methods,
have provided evidence that AF is spatially organized. The objective of
this study was to demonstrate the presence of spatial and temporal
periodicity during AF.
Methods and Results—We used a combination of high-resolution
video imaging, ECG recordings, and spectral analysis to
identify sequential wave fronts with temporal periodicity and similar
spatial patterns of propagation during 20 episodes of AF in 6
Langendorff-perfused sheep hearts. Spectral analysis of AF
demonstrated multiple narrow-band peaks with a single dominant peak in
all cases (mean, 9.4±2.6 Hz; cycle length, 112±26 ms). Evidence of
spatiotemporal periodicity was found in 12 of 20 optical
recordings of the right atrium (RA) and in all (n=19)
recordings of the left atrium (LA). The cycle length of
spatiotemporal periodic waves correlated with the dominant frequency of
their respective optical pseudo-ECGs (LA:
R2=0.99, slope=0.94 [95% CI, 0.88 to
0.99]; RA: R2=0.97, slope=0.92 [95% CI,
0.80 to 1.03]). The dominant frequency of the LA pseudo-ECG alone
correlated with the global bipolar atrial EG
(R2=0.76, slope=0.75 [95% CI, 0.52 to
0.99]). In specific examples, sources of periodic activity were seen
as rotors in the epicardial sheet or as periodic breakthroughs that
most likely represented transmural pectinate muscle
reentry. However, in the majority of cases, periodic waves were seen to
enter the mapping area from the edge of the field of view.
Conclusions—Reentry in anatomically or functionally determined
circuits forms the basis of spatiotemporal periodic activity during AF.
The cycle length of sources in the LA determines the dominant peak in
the frequency spectra in this experimental model of AF.
© 1998 American Heart Association, Inc.
Basic Science Reports
Spatiotemporal Periodicity During Atrial Fibrillation in the Isolated Sheep Heart
Key Words: atrium • arrhythmia • mapping • imaging • Fourier analysis
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