Journal article

Endocardial-Epicardial Phase Mapping of Prolonged Persistent Atrial Fibrillation Recordings High Prevalence of Dissociated Activation Patterns

Ramanathan Parameswaran, Jonathan M Kalman, Alistair Royse, John Goldblatt, Marco Larobina, Troy Watts, Tomos E Walters, Chrishan J Nalliah, Geoffrey Wong, Ahmed Al-Kaisey, Robert Douglas Anderson, Aleksandr Voskoboinik, Hariharan Sugumar, David Chieng, Prashanthan Sanders, Peter M Kistler, Edward P Gerstenfeld, Geoffrey Lee



BACKGROUND: Endocardial-epicardial dissociation and focal breakthroughs in humans with atrial fibrillation (AF) have been recently demonstrated using activation mapping of short 10-second AF segments. In the current study, we used simultaneous endo-epi phase mapping to characterize endo-epi activation patterns on long segments of human persistent AF. METHODS: Simultaneous intraoperative mapping of endo- and epicardial lateral right atrium wall was performed in patients with persistent AF using 2 high-density grid catheters (16 electrodes, 3 mm spacing). Filtered unipolar and bipolar electrograms of continuous 2-minute AF recordings and electrodes locations were exported for phase analyses. W..

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Funding Acknowledgements

Drs Parameswaran, Nalliah, Wong, Anderson, Voskoboinik, and Sugumar are supported by the National Health and Medical Research Council (NHMRC) research scholarship. Drs Kalman and Sanders are supported by practitioner fellowships from the NHMRC. Dr Sanders is also supported by practitioner fellowship from the NHF. Dr Kalman has reported receiving research support from Biosense Webster, Boston Scientific, Abbott, and Medtronic. Dr Gerstenfeld has received research funding from Biosense-Webster.