Abstract 14596: The Preferable Anatomical Location of the Rotational Reentrant Circuit in Patients With Atrial Fibrillation: Analysis by the Non-Contact Mapping
Background: It has been suggested that the rotational reentry may exist and maintain the atrial fibrillation (AF). However, it remains unclear whether the rotational reentry exists at the stable location during AF or not. Furthermore, it is also unclear if there is a preferable anatomical site of origin in the rotational reentry during AF. Objective: The purpose of this study was to examine the location of rotational reentry and elucidate its anatomical stability during AF.
Methods: Endocardial mapping of the left atrium (LA) was performed using non-contact mapping system (Ensite 3000) in 30 patients with AF (16 paroxysmal and 14 persistent AF). The prevalence and location of rotational reentry and its stability were examined in 8 divided areas of left atrium (roof, left pulmonary vein, right pulmonary vein, left atrial appendage, anterior, septum, lateral and posterior) during AF. To identify the continuity of rotational reentry, rotational reentry was classified into 3 categories; rotational reentry continued at the stable site (S-RR), rotational reentry which was observed intermittently at the same site (I-RR) and rotational reentry which was observed at different locations (D-RR).
Results: Seventy-four rotational reentries were observed during 1000 millisecond recording periods. The number of rotational reentries observed at the roof, left pulmonary vein, right pulmonary vein, left atrial appendage, anterior LA, septum, lateral LA and posterior LA were 15, 2, 10, 0, 43, 3, 0 and 1, respectively. The anterior LA showed the highest prevalence of rotational reentry (P<0.001) compared with other areas. The number of S-RR, I-RR and D-RR were 6, 25 and 43, respectively. The prevalence of I-RR and D-RR were both significantly higher than S-RR (25 vs. 6, p=0.02, and 43 vs. 6, p<0.001, respectively).
Conclusion: The anterior LA was the preferential site of rotational reentry. However, few rotational reentries continued at the stable site. Most of the rotational reentries were observed intermittently at the same site or observed at different locations, suggesting the absence of stationary rotational reentry fixed at the stable location during AF.
- © 2013 by American Heart Association, Inc.