title: Regional disparities of endocardial atrial activation in paroxysmal atrial fibrillation.
abstract: Previous experimental data suggest that atrial activity is homogeneously distributed during paroxysmal atrial fibrillation (AFib). Little is known about this in human paroxysmal AFib.
  
  
  METHODS
  Twenty-five men and two women (mean age 49 +/- 11 years; five with structural heart disease) with paroxysmal AFib for a mean 5 +/- 6.2 years despite the use of a mean of 3.6 +/- 1.7 antiarrhythmic drugs underwent atrial mapping. The right atrium was divided into four regions: posterior (intercaval), lateral, anterior, and septal. A 14-pole catheter was positioned to assess complex electrical activity defined as the duration of continuous electrical activity or electrograms with FF intervals < 100 ms for 60 seconds (expressed as percentage of time). In addition, the left atrium (divided into three regions: posterior, anterior, and septal) was explored in 12 patients with a multipolar catheter.
  
  
  RESULTS
  The complex electrical activity time between all the regions explored was significantly different. In the right atrium, the septal (74% +/- 32%; P = 0.02) and the posterior (63% +/- 32%; P = 0.04) areas were significantly more disorganized than the lateral (22% +/-23%) and anterior (21% +/- 26%) regions. In the left atrium, complex electrical activity was predominant and widely distributed (posterior: 87% +/- 11%; septal: 65% +/- 27%) except in the appendage area (anterior region: 18% +/- 14%).
  
  
  CONCLUSIONS
  Quantitative assessment of complex electrical activity in both atria in humans shows heterogeneous temporal and spatial distribution. This may have implications for guiding catheter ablation of AFib.
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Jaïs
authors.forename: M
authors.initials: M
authors.lastname: Haïssaguerre
authors.forename: D C
authors.initials: DC
authors.lastname: Shah
authors.forename: S
authors.initials: S
authors.lastname: Chouairi
authors.forename: J
authors.initials: J
authors.lastname: Clémenty
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000473:pathology / Q000503:physiopathology*; D016275:Atrial Function; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D004562:Electrocardiography; D004594:Electrophysiology; D004699:Endocardium / Q000503:physiopathology*; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006339:Heart Rate; D006346:Heart Septum / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014683:Vena Cava, Superior / Q000473:pathology / Q000503:physiopathology
chemical_list: D000889:Anti-Arrhythmia Agents