title: Presence and stability of rotors in atrial fibrillation: evidence and therapeutic implications.
abstract: Rotor-guided ablation has opened new perspectives into the therapy of atrial fibrillation (AF). Analysis of the spatio-temporal cardiac excitation patterns in the frequency and phase domains has demonstrated the importance of rotors in research models of AF, however, the dynamics and role of rotors in human AF are still controversial. In this review, the current knowledge gained through research models and patient data that support the notion that rotors are key players in AF maintenance is summarized. We report and discuss discrepancies regarding rotor prevalence and stability in various studies, which can be attributed in part to methodological differences among mapping systems. Future research for validation and improvement of current clinical electrophysiology mapping technologies will be crucial for developing mechanistic-based selection and application of the best therapeutic strategy for individual AF patient, being it, pharmaceutical, ablative, or other approach.
authors.affiliation: ITACA, Universitat Politèscnica de València, Valencia, Spain.
authors.forename: María S
authors.initials: MS
authors.lastname: Guillem
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: Andreu M
authors.initials: AM
authors.lastname: Climent
authors.affiliation: ITACA, Universitat Politèscnica de València, Valencia, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Rodrigo
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Avilés
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid, Spain Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Atienza
authors.affiliation: Center for Arrhythmia Research, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, USA oberen@umich.edu.
authors.forename: Omer
authors.initials: O
authors.lastname: Berenfeld
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D006329:Heart Conduction System / Q000502:physiology / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D015995:Prevalence
keywords: Atrial fibrillation; Body surface mapping; Dominant frequency; Fourier transform; Phase mapping; Rotors