Electrophysiologic characteristics in initiation of paroxysmal atrial fibrillation from a focal area

T M Lu, C T Tai, M H Hsieh, C F Tsai, Y K Lin, W C Yu, H M Tsao, S H Lee, Y A Ding, M S Chang, S A Chen

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Abstract

OBJECTIVES: We investigated the electrophysiologic characteristics in the initiation of paroxysmal atrial fibrillation (PAF) from a focal area.

BACKGROUND: The electrophysiologic characteristics in the initiation of PAF are still not clear.

METHODS: The study group consisted of 77 patients (M/F = 65/12, age 66 +/- 12 years) with frequent episodes of PAF; we analyzed: 1) 15 cycle lengths of electrical activity before the onset of atrial fibrillation (AF); 2) coupling interval (CI) of the first ectopic beat just before the initiation of AF; and 3) the prematurity of an ectopic beat (prematurity index [PI] = CI/mean of preceding 15 cycle lengths).

RESULTS: A total of 111 episodes of sustained AF were identified. Two patterns of AF initiation were observed: group I (59/111, 53%) included the episodes preceded by cycle length oscillation, and group II (52/111, 47%) included the episodes initiated by a single ectopic beat with preceding cycle length relatively constant. The PI of group I episodes was significantly greater than that of group II (0.41 +/- 0.12 vs. 0.34 +/- 0.10, p < 0.01). The CI (267 +/- 54 ms vs. 217 +/- 55 ms, p < 0.05), AF1 (194 +/- 36 ms vs. 153 +/- 37 ms, p < 0.05) and PI (0.49 +/- 0.13 vs. 0.37 +/- 0.11, p < 0.01) of the AF episodes from the superior vena cava (SVC) were significantly longer and greater than those of AF episodes from pulmonary veins (PVs).

CONCLUSIONS: In patients with PAF originating from PVs or the SVC, two major initiating patterns were found. Moreover, the electrophysiologic characteristics in the initiation of AF originating from the SVC were also different from those of AF initiating from the PVs.

Original languageEnglish
Pages (from-to)1658-64
Number of pages7
JournalJournal of the American College of Cardiology
Volume37
Issue number6
Publication statusPublished - May 2001

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Atrial Fibrillation
Superior Vena Cava
Pulmonary Veins

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation
  • Atrial Premature Complexes
  • Cardiomegaly
  • Catheter Ablation
  • Chi-Square Distribution
  • Echocardiography
  • Electrocardiography, Ambulatory
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Heart Atria
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Veins
  • Severity of Illness Index
  • Time Factors
  • Vena Cava, Superior
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

Electrophysiologic characteristics in initiation of paroxysmal atrial fibrillation from a focal area. / Lu, T M; Tai, C T; Hsieh, M H; Tsai, C F; Lin, Y K; Yu, W C; Tsao, H M; Lee, S H; Ding, Y A; Chang, M S; Chen, S A.

In: Journal of the American College of Cardiology, Vol. 37, No. 6, 05.2001, p. 1658-64.

Research output: Contribution to journalArticle

Lu, TM, Tai, CT, Hsieh, MH, Tsai, CF, Lin, YK, Yu, WC, Tsao, HM, Lee, SH, Ding, YA, Chang, MS & Chen, SA 2001, 'Electrophysiologic characteristics in initiation of paroxysmal atrial fibrillation from a focal area', Journal of the American College of Cardiology, vol. 37, no. 6, pp. 1658-64.
Lu, T M ; Tai, C T ; Hsieh, M H ; Tsai, C F ; Lin, Y K ; Yu, W C ; Tsao, H M ; Lee, S H ; Ding, Y A ; Chang, M S ; Chen, S A. / Electrophysiologic characteristics in initiation of paroxysmal atrial fibrillation from a focal area. In: Journal of the American College of Cardiology. 2001 ; Vol. 37, No. 6. pp. 1658-64.
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abstract = "OBJECTIVES: We investigated the electrophysiologic characteristics in the initiation of paroxysmal atrial fibrillation (PAF) from a focal area.BACKGROUND: The electrophysiologic characteristics in the initiation of PAF are still not clear.METHODS: The study group consisted of 77 patients (M/F = 65/12, age 66 +/- 12 years) with frequent episodes of PAF; we analyzed: 1) 15 cycle lengths of electrical activity before the onset of atrial fibrillation (AF); 2) coupling interval (CI) of the first ectopic beat just before the initiation of AF; and 3) the prematurity of an ectopic beat (prematurity index [PI] = CI/mean of preceding 15 cycle lengths).RESULTS: A total of 111 episodes of sustained AF were identified. Two patterns of AF initiation were observed: group I (59/111, 53{\%}) included the episodes preceded by cycle length oscillation, and group II (52/111, 47{\%}) included the episodes initiated by a single ectopic beat with preceding cycle length relatively constant. The PI of group I episodes was significantly greater than that of group II (0.41 +/- 0.12 vs. 0.34 +/- 0.10, p < 0.01). The CI (267 +/- 54 ms vs. 217 +/- 55 ms, p < 0.05), AF1 (194 +/- 36 ms vs. 153 +/- 37 ms, p < 0.05) and PI (0.49 +/- 0.13 vs. 0.37 +/- 0.11, p < 0.01) of the AF episodes from the superior vena cava (SVC) were significantly longer and greater than those of AF episodes from pulmonary veins (PVs).CONCLUSIONS: In patients with PAF originating from PVs or the SVC, two major initiating patterns were found. Moreover, the electrophysiologic characteristics in the initiation of AF originating from the SVC were also different from those of AF initiating from the PVs.",
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TY - JOUR

T1 - Electrophysiologic characteristics in initiation of paroxysmal atrial fibrillation from a focal area

AU - Lu, T M

AU - Tai, C T

AU - Hsieh, M H

AU - Tsai, C F

AU - Lin, Y K

AU - Yu, W C

AU - Tsao, H M

AU - Lee, S H

AU - Ding, Y A

AU - Chang, M S

AU - Chen, S A

PY - 2001/5

Y1 - 2001/5

N2 - OBJECTIVES: We investigated the electrophysiologic characteristics in the initiation of paroxysmal atrial fibrillation (PAF) from a focal area.BACKGROUND: The electrophysiologic characteristics in the initiation of PAF are still not clear.METHODS: The study group consisted of 77 patients (M/F = 65/12, age 66 +/- 12 years) with frequent episodes of PAF; we analyzed: 1) 15 cycle lengths of electrical activity before the onset of atrial fibrillation (AF); 2) coupling interval (CI) of the first ectopic beat just before the initiation of AF; and 3) the prematurity of an ectopic beat (prematurity index [PI] = CI/mean of preceding 15 cycle lengths).RESULTS: A total of 111 episodes of sustained AF were identified. Two patterns of AF initiation were observed: group I (59/111, 53%) included the episodes preceded by cycle length oscillation, and group II (52/111, 47%) included the episodes initiated by a single ectopic beat with preceding cycle length relatively constant. The PI of group I episodes was significantly greater than that of group II (0.41 +/- 0.12 vs. 0.34 +/- 0.10, p < 0.01). The CI (267 +/- 54 ms vs. 217 +/- 55 ms, p < 0.05), AF1 (194 +/- 36 ms vs. 153 +/- 37 ms, p < 0.05) and PI (0.49 +/- 0.13 vs. 0.37 +/- 0.11, p < 0.01) of the AF episodes from the superior vena cava (SVC) were significantly longer and greater than those of AF episodes from pulmonary veins (PVs).CONCLUSIONS: In patients with PAF originating from PVs or the SVC, two major initiating patterns were found. Moreover, the electrophysiologic characteristics in the initiation of AF originating from the SVC were also different from those of AF initiating from the PVs.

AB - OBJECTIVES: We investigated the electrophysiologic characteristics in the initiation of paroxysmal atrial fibrillation (PAF) from a focal area.BACKGROUND: The electrophysiologic characteristics in the initiation of PAF are still not clear.METHODS: The study group consisted of 77 patients (M/F = 65/12, age 66 +/- 12 years) with frequent episodes of PAF; we analyzed: 1) 15 cycle lengths of electrical activity before the onset of atrial fibrillation (AF); 2) coupling interval (CI) of the first ectopic beat just before the initiation of AF; and 3) the prematurity of an ectopic beat (prematurity index [PI] = CI/mean of preceding 15 cycle lengths).RESULTS: A total of 111 episodes of sustained AF were identified. Two patterns of AF initiation were observed: group I (59/111, 53%) included the episodes preceded by cycle length oscillation, and group II (52/111, 47%) included the episodes initiated by a single ectopic beat with preceding cycle length relatively constant. The PI of group I episodes was significantly greater than that of group II (0.41 +/- 0.12 vs. 0.34 +/- 0.10, p < 0.01). The CI (267 +/- 54 ms vs. 217 +/- 55 ms, p < 0.05), AF1 (194 +/- 36 ms vs. 153 +/- 37 ms, p < 0.05) and PI (0.49 +/- 0.13 vs. 0.37 +/- 0.11, p < 0.01) of the AF episodes from the superior vena cava (SVC) were significantly longer and greater than those of AF episodes from pulmonary veins (PVs).CONCLUSIONS: In patients with PAF originating from PVs or the SVC, two major initiating patterns were found. Moreover, the electrophysiologic characteristics in the initiation of AF originating from the SVC were also different from those of AF initiating from the PVs.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Atrial Fibrillation

KW - Atrial Premature Complexes

KW - Cardiomegaly

KW - Catheter Ablation

KW - Chi-Square Distribution

KW - Echocardiography

KW - Electrocardiography, Ambulatory

KW - Electrophysiologic Techniques, Cardiac

KW - Female

KW - Heart Atria

KW - Humans

KW - Male

KW - Middle Aged

KW - Pulmonary Veins

KW - Severity of Illness Index

KW - Time Factors

KW - Vena Cava, Superior

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

UR - http://www.ncbi.nlm.nih.gov/pubmed/11345381

M3 - Article

C2 - 11345381

VL - 37

SP - 1658

EP - 1664

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 6

ER -