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

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

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

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 language	English
Pages (from-to)	1658-64
Number of pages	7
Journal	Journal of the American College of Cardiology
Volume	37
Issue number	6
Publication status	Published - May 2001

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

@article{444b0792f60a4571a044ed66b0b640f8,

title = "Electrophysiologic characteristics in initiation of paroxysmal atrial fibrillation from a focal area",

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.",

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",

author = "Lu, {T M} and Tai, {C T} and Hsieh, {M H} and Tsai, {C F} and Lin, {Y K} and Yu, {W C} and Tsao, {H M} and Lee, {S H} and Ding, {Y A} and Chang, {M S} and Chen, {S A}",

year = "2001",

month = may,

language = "English",

volume = "37",

pages = "1658--64",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier USA",

number = "6",

}

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

SN - 0735-1097

VL - 37

SP - 1658

EP - 1664

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 6

ER -

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

Abstract

Keywords

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