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- ISSN
- 0009-7322
- eISSN
- 1524-4539
- DOI
- 10.1161/CIRCULATIONAHA.110.945709
- pmid
- 20855661
- Publisher site
- See Article on Publisher Site
Abstract
Noninvasive Characterization of Epicardial Activation in Humans With Diverse Atrial Fibrillation Patterns Phillip S. Cuculich, MD*; Yong Wang, PhD*; Bruce D. Lindsay, MD; Mitchell N. Faddis, MD, PhD; Richard B. Schuessler, PhD; Ralph J. Damiano, Jr, MD; Li Li, MS; Yoram Rudy, PhD Background—Various mechanisms of atrial fibrillation (AF) have been demonstrated experimentally. Invasive methods to study these mechanisms in humans have limitations, precluding continuous mapping of both atria with sufficient resolution. In this article, we present continuous biatrial epicardial activation sequences of AF in humans using noninvasive electrocardiographic imaging (ECGI). Methods and Results—In the testing phase, ECGI accuracy was evaluated by comparing ECGI with coregistered CARTO images during atrial pacing in 6 patients. Additionally, correlative observations from catheter mapping and ablation were compared with ECGI in 3 patients. In the study phase, ECGI maps during AF in 26 patients were analyzed for mechanisms and complexity. ECGI noninvasively imaged the low-amplitude signals of AF in a wide range of patients (97% procedural success). Spatial accuracy for determining initiation sites from pacing was 6 mm. Locations critical to maintenance of AF identified during catheter ablation were identified by ECGI; ablation near these sites restored sinus rhythm. In the study phase,
Journal
Circulation – Wolters Kluwer Health
Published: Oct 1, 2010