Mechanisms responsible for the initiation and maintenance of atrial fibrillation assessed by noncontact mapping system

초록

A noncontact mapping system (NMS) was used to assess whether a single reentry or focal activity is important. in the initiation and maintenance of atrial fibrillation (AF) and their relationship with underlying structures in 26 patients with AF. Four different mechanisms responsible for the initiation and maintenance of AF were observed: 1) Focally triggered AF was 62%: 2) Focally driven AF was 27%: atrial premature contraction (APC) not only initiated AF but also played a role in the maintenance of AF. 3) Mixed type AF (Focally triggered+driven) was 8% and 4) Indeterminate type AF was 19%. Wave breakup occurred at the septopulmonary bundle near the RSPV ostium in 84.6% and posterior roof of LA in 53.8%. The origin of APCs responsible for AF initiation in post-cardioversion reinitiated AF were similar with those of spontaneous AF in 86.7% of patients. A NMS is useful to identify the mechanisms of AF and their relationship with the underlying anatomical structures.