Journal
CANADIAN JOURNAL OF CARDIOLOGY
Volume 32, Issue 10, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cjca.2015.11.020
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Funding
- Erasmus Medical Center fellowship
- Dutch Heart Foundation [2012T0046]
- LSH-Impulse Grant [40-43100-98-008]
- CoolSingel Foundation [212]
- Bayer
- Boehringer Ingelheim
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Focal waves appear frequently at the epicardium during persistent atrial fibrillation (AF), however, the origin of these waves is under debate. We performed simultaneous endo-epicardial mapping of the right atrial wall during longstanding persistent AF in a patient undergoing cardiac surgery. During 10 seconds 53 and 59 focal waves appeared at random at respectively the endocardium and epicardium. Repetitive focal activity did not last longer than 3 cycles. Transmural asynchrony and conduction might be the origin of focal waves. Asynchronous propagation of fibrillation waves in 3 dimensions would stabilize the arrhythmia and could explain the limited success of persistent AF ablation.
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