(Circulation. 2001;103:2631.)
© 2001 American Heart Association, Inc.
Basic Science Reports |
Left-to-Right Gradient of Atrial Frequencies During Acute Atrial Fibrillation in the Isolated Sheep Heart
From the Departments of Pharmacology (R.M., O.B., J.C., F.S., J.J.) and Cardiology (M.M.), SUNY Upstate Medical University, Syracuse, NY.
Correspondence to José Jalife, MD, Department of Pharmacology, SUNY Upstate Medical University, 766 Irving Ave, Syracuse, NY 13210. E-mail jalifej{at}upstate.edu
Background—Recent studies demonstrated spatiotemporal organization in atrial fibrillation (AF). We hypothesized that waves emanating from sources in the left atrium (LA) undergo fragmentation, resulting in left-to-right frequency gradient. Our objective was to characterize impulse propagation across Bachmann’s bundle (BB) and the inferoposterior pathway (IPP) during AF.
Methods and Results—In 13 Langendorff-perfused sheep hearts, AF was induced in the presence of acetylcholine (ACh). Fast Fourier transform of optical and bipolar electrode recordings was performed. Frequency-dependent changes in the left-to-right dominant frequency (DF) gradient were studied by perfusing D600 (2 µmol/L) and by increasing ACh concentration from 0.2 to 0.5 µmol/L. BB and IPP were subsequently ablated. At baseline, a left-to-right decrease in DFs occurred along BB and IPP, resulting in an LA–right atrium (RA) frequency gradient of 5.7±1.4 Hz. Left-to-right impulse propagation was present in 81±5% and 80±10% of cases along BB and IPP, respectively. D600 decreased the highest LA frequency from 19.7±4.4 to 16.2±3.9 Hz (P<0.01) and raised RA DF from 8.6±2.0 to 10.7±1.8 Hz (P<0.05). An increase in ACh concentration increased the LA-RA frequency gradient from 4.9±1.8 to 8.9±1.8 Hz (P<0.05). Ablation of BB and IPP decreased RA DF from 10.9±1.2 to 9.0±1.5 Hz (P<0.01) without affecting LA DF (16.8±1.5 versus 16.9±1.8 Hz, P=NS).
Conclusions—Left-to-right impulse propagation and frequency-dependent changes in the LA-RA frequency gradient during AF strongly support the hypothesis that this arrhythmia is the result of high-frequency periodic sources in the LA, with fibrillatory conduction away from such sources.
Key Words: arrhythmia • fibrillation • Fourieranalysis • mapping
This article has been cited by other articles:
 |
|
 |
|
  K. Nishida, G. Michael, D. Dobrev, and S. Nattel Animal models for atrial fibrillation: clinical insights and scientific opportunities Europace, October 29, 2009; (2009) eup328v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Arenal, T. Datino, L. Atea, F. Atienza, E. Gonzalez-Torrecilla, J. Almendral, L. Castilla, P. L. Sanchez, and F. Fernandez-Aviles Dominant frequency differences in atrial fibrillation patients with and without left ventricular systolic dysfunction Europace, April 1, 2009; 11(4): 450 - 457. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. Berntsen, A. Cheng, H. Calkins, and R. D. Berger Evaluation of spatiotemporal organization of persistent atrial fibrillation with time- and frequency-domain measures in humans Europace, March 1, 2009; 11(3): 316 - 323. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Rostock, D. Steven, B. Hoffmann, H. Servatius, I. Drewitz, K. Sydow, K. Mullerleile, R. Ventura, K. Wegscheider, T. Meinertz, et al. Chronic Atrial Fibrillation Is a Biatrial Arrhythmia: Data from Catheter Ablation of Chronic Atrial Fibrillation Aiming Arrhythmia Termination Using a Sequential Ablation Approach Circ Arrhythm Electrophysiol, December 1, 2008; 1(5): 344 - 353. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Liang, Q. Pan, Y. Liu, H. Chen, J. Li, R. Brugada, P. Brugada, K. Hong, G. J. Perez, C. Zhao, et al. High sensitivity of the sheep pulmonary vein antrum to acetylcholine stimulation J Appl Physiol, July 1, 2008; 105(1): 293 - 298. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Rostock, D. Steven, B. Lutomsky, H. Servatius, I. Drewitz, H. Klemm, K. Mullerleile, R. Ventura, T. Meinertz, and S. Willems Atrial fibrillation begets atrial fibrillation in the pulmonary veins on the impact of atrial fibrillation on the electrophysiological properties of the pulmonary veins in humans. J. Am. Coll. Cardiol., June 3, 2008; 51(22): 2153 - 2160. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Oral, A. Chugh, E. Good, T. Crawford, J. F. Sarrazin, M. Kuhne, N. Chalfoun, D. Wells, W. Boonyapisit, N. Gadeela, et al. Randomized Evaluation of Right Atrial Ablation After Left Atrial Ablation of Complex Fractionated Atrial Electrograms for Long-Lasting Persistent Atrial Fibrillation Circ Arrhythm Electrophysiol, April 1, 2008; 1(1): 6 - 13. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. K. Voeller, M. S. Bailey, A. Zierer, S. C. Lall, S.-i. Sakamoto, K. Aubuchon, J. S. Lawton, N. Moazami, C. B. Huddleston, N. A. Munfakh, et al. Isolating the entire posterior left atrium improves surgical outcomes after the Cox maze procedure. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 870 - 877. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. D. Lindsay Is Pulmonary Vein Antrum Isolation a Critical Determinant of Recurrent Arrhythmias After Ablation of Atrial Fibrillation? J. Am. Coll. Cardiol., August 28, 2007; 50(9): 875 - 876. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Sanders, M. Hocini, P. Jais, F. Sacher, L.-F. Hsu, Y. Takahashi, M. Rotter, T. Rostock, C. J. Nalliah, J. Clementy, et al. Complete isolation of the pulmonary veins and posterior left atrium in chronic atrial fibrillation. Long-term clinical outcome Eur. Heart J., August 1, 2007; 28(15): 1862 - 1871. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Calkins, J. Brugada, D. L. Packer, R. Cappato, S.-A. Chen, H. J.G. Crijns, R. J. Damiano Jr, D. W. Davies, D. E. Haines, M. Haissaguerre, et al. HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up: A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation Developed in partnership with the European Heart Rhythm Association (EHRA) and the European Cardiac Arrhythmia Society (ECAS); in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Endorsed and Approved by the governing bodies of the American College of Cardiology, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, and the Heart Rhythm Society. Europace, June 1, 2007; 9(6): 335 - 379. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Atienza, J. Almendral, J. Moreno, R. Vaidyanathan, A. Talkachou, J. Kalifa, A. Arenal, J. P. Villacastin, E. G. Torrecilla, A. Sanchez, et al. Activation of Inward Rectifier Potassium Channels Accelerates Atrial Fibrillation in Humans: Evidence for a Reentrant Mechanism Circulation, December 5, 2006; 114(23): 2434 - 2442. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. H. Everett IV, E. E. Wilson, S. Verheule, J. M. Guerra, S. Foreman, and J. E. Olgin Structural atrial remodeling alters the substrate and spatiotemporal organization of atrial fibrillation: a comparison in canine models of structural and electrical atrial remodeling Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2911 - H2923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 651 - 745. [Full Text] [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): e149 - e246. [Full Text] [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): e257 - e354. [Full Text] [PDF]
|
|
|
|
|
|
T.-J. Cha, J. R. Ehrlich, D. Chartier, X.-Y. Qi, L. Xiao, and S. Nattel Kir3-Based Inward Rectifier Potassium Current: Potential Role in Atrial Tachycardia Remodeling Effects on Atrial Repolarization and Arrhythmias Circulation, April 11, 2006; 113(14): 1730 - 1737. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-J. Lin, C.-T. Tai, T. Kao, H.-W. Tso, S. Higa, H.-M. Tsao, S.-L. Chang, M.-H. Hsieh, and S.-A. Chen Frequency Analysis in Different Types of Paroxysmal Atrial Fibrillation J. Am. Coll. Cardiol., April 4, 2006; 47(7): 1401 - 1407. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Takahashi, P. Jais, M. Hocini, P. Sanders, M. Rotter, T. Rostock, L.-F. Hsu, F. Sacher, J. Clementy, and M. Haissaguerre Shortening of Fibrillatory Cycle Length in the Pulmonary Vein During Vagal Excitation J. Am. Coll. Cardiol., February 21, 2006; 47(4): 774 - 780. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Kalifa, K. Tanaka, A. V. Zaitsev, M. Warren, R. Vaidyanathan, D. Auerbach, S. Pandit, K. L. Vikstrom, R. Ploutz-Snyder, A. Talkachou, et al. Mechanisms of Wave Fractionation at Boundaries of High-Frequency Excitation in the Posterior Left Atrium of the Isolated Sheep Heart During Atrial Fibrillation Circulation, February 7, 2006; 113(5): 626 - 633. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-J. Lin, C.-T. Tai, T. Kao, H.-W. Tso, J.-L. Huang, S. Higa, Y. Yuniadi, B.-H. Huang, T.-Y. Liu, P.-C. Lee, et al. Electrophysiological Characteristics and Catheter Ablation in Patients With Paroxysmal Right Atrial Fibrillation Circulation, September 20, 2005; 112(12): 1692 - 1700. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Sanders, O. Berenfeld, M. Hocini, P. Jais, R. Vaidyanathan, L.-F. Hsu, S. Garrigue, Y. Takahashi, M. Rotter, F. Sacher, et al. Spectral Analysis Identifies Sites of High-Frequency Activity Maintaining Atrial Fibrillation in Humans Circulation, August 9, 2005; 112(6): 789 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Ishii, R. B. Schuessler, S. L. Gaynor, K. Yamada, A. S. Fu, J. P. Boineau, and R. J. Damiano Jr Inflammation of Atrium After Cardiac Surgery Is Associated With Inhomogeneity of Atrial Conduction and Atrial Fibrillation Circulation, June 7, 2005; 111(22): 2881 - 2888. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Zhang, C. J. Garratt, J. Zhu, and A. V. Holden Role of up-regulation of IK1 in action potential shortening associated with atrial fibrillation in humans Cardiovasc Res, June 1, 2005; 66(3): 493 - 502. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Nygren, A. E. Lomax, and W. R. Giles Heterogeneity of action potential durations in isolated mouse left and right atria recorded using voltage-sensitive dye mapping Am J Physiol Heart Circ Physiol, December 1, 2004; 287(6): H2634 - H2643. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Khan Identifying and understanding the role of pulmonary vein activity in atrial fibrillation Cardiovasc Res, December 1, 2004; 64(3): 387 - 394. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Lazar, S. Dixit, F. E. Marchlinski, D. J. Callans, and E. P. Gerstenfeld Presence of Left-to-Right Atrial Frequency Gradient in Paroxysmal but Not Persistent Atrial Fibrillation in Humans Circulation, November 16, 2004; 110(20): 3181 - 3186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Haissaguerre, P. Sanders, M. Hocini, L.-F. Hsu, D. C. Shah, C. Scavee, Y. Takahashi, M. Rotter, J.-L. Pasquie, S. Garrigue, et al. Changes in Atrial Fibrillation Cycle Length and Inducibility During Catheter Ablation and Their Relation to Outcome Circulation, June 22, 2004; 109(24): 3007 - 3013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. H. Everett IV, S. Verheule, E. E. Wilson, S. Foreman, and J. E. Olgin Left atrial dilatation resulting from chronic mitral regurgitation decreases spatiotemporal organization of atrial fibrillation in left atrium Am J Physiol Heart Circ Physiol, June 1, 2004; 286(6): H2452 - H2460. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Nitta, Y. Ishii, Y. Miyagi, H. Ohmori, S.-i. Sakamoto, and S. Tanaka Concurrent multiple left atrial focal activations with fibrillatory conduction and right atrial focal or reentrant activation as the mechanism in atrial fibrillation J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 770 - 778. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Sarmast, A. Kolli, A. Zaitsev, K. Parisian, A. S Dhamoon, P. K Guha, M. Warren, J. M.B Anumonwo, S. M Taffet, O. Berenfeld, et al. Cholinergic atrial fibrillation: IK,ACh gradients determine unequal left/right atrial frequencies and rotor dynamics Cardiovasc Res, October 1, 2003; 59(4): 863 - 873. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. H. Everett IV, J. G. Akar, L.-C. Kok, J. R. Moorman, and D. E. Haines Use of global atrial fibrillation organization to optimize the success of burst pace termination J. Am. Coll. Cardiol., November 20, 2002; 40(10): 1831 - 1840. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Zhou, C.-M. Chang, T.-J. Wu, Y. Miyauchi, Y. Okuyama, A. M. Park, A. Hamabe, C. Omichi, H. Hayashi, L. A. Brodsky, et al. Nonreentrant focal activations in pulmonary veins in canine model of sustained atrial fibrillation Am J Physiol Heart Circ Physiol, September 1, 2002; 283(3): H1244 - H1252. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Berenfeld, A. V. Zaitsev, S. F. Mironov, A. M. Pertsov, and J. Jalife Frequency-Dependent Breakdown of Wave Propagation Into Fibrillatory Conduction Across the Pectinate Muscle Network in the Isolated Sheep Right Atrium Circ. Res., June 14, 2002; 90(11): 1173 - 1180. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Kneller, R. Zou, E. J. Vigmond, Z. Wang, L. J. Leon, and S. Nattel Cholinergic Atrial Fibrillation in a Computer Model of a Two-Dimensional Sheet of Canine Atrial Cells With Realistic Ionic Properties Circ. Res., May 17, 2002; 90 (9): e73 - e87. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Ideker, J. Huang, V. Fast, and W. M. Smith Recent Fibrillation Studies: Attempts to Wrest Order From Disorder Circ. Res., December 7, 2001; 89(12): 1089 - 1091. [Full Text] [PDF]
|
|
|
|
|
|
F. H. Samie, O. Berenfeld, J. Anumonwo, S. F. Mironov, S. Udassi, J. Beaumont, S. Taffet, A. M. Pertsov, and J. Jalife Rectification of the Background Potassium Current: A Determinant of Rotor Dynamics in Ventricular Fibrillation Circ. Res., December 7, 2001; 89(12): 1216 - 1223. [Abstract] [Full Text] [PDF]
|
|