title: Noninvasive mapping of human atrial fibrillation.
abstract: BACKGROUND
  Invasive high-density mapping of atrial fibrillation (AF) has revealed different patterns of atrial activation ranging from single wavefronts to disorganized activation with multiple simultaneous wavefronts. Whether or not similar activation patterns can also be observed using body surface recordings is currently unknown, and was consequently evaluated in this study.
  
  
  RESULTS
  Surface electrocardiographic mapping was performed in 14 patients (age 68 +/- 14 years) with persistent AF (AF duration 12 +/- 18 months). A total of 56 electrocardiographic leads were placed on the chest over the atria on the front (n = 40) and on the back (n = 16). Using 240-second recordings, wavefront propagation maps were automatically computed and visually classified as either type I (single wavefront), II (single wavefront with wave breakages and splitting), or III (multiple simultaneous wavefronts). Almost half of the patients (n = 6) presented most predominantly type III atrial activation, while six patients mostly presented type I activation. The rest of the patients (n = 2) presented mixed type I and type III activations. This classification showed to be highly reproducible over 4 minutes.
  
  
  CONCLUSIONS
  Using electrocardiographic body surface mapping during AF, interindividual differences of atrial fibrillatory activation can be observed. The surface activation pattern during AF shows an excellent short-term reproducibility.
authors.affiliation: Instituto ITACA, Universidad Politécnica de Valencia, Valencia, Spain. mguisan@eln.upv.es
authors.forename: Maria S
authors.initials: MS
authors.lastname: Guillem
authors.forename: Andreu M
authors.initials: AM
authors.lastname: Climent
authors.forename: Francisco
authors.initials: F
authors.lastname: Castells
authors.forename: Daniela
authors.initials: D
authors.lastname: Husser
authors.forename: Jose
authors.initials: J
authors.lastname: Millet
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.forename: Christopher
authors.initials: C
authors.lastname: Piorkowski
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
mesh_terms: D000368:Aged; D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis*; D018780:Body Surface Potential Mapping / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity