Key result
High-resolution mapping links focal activation patterns to AF pathophysiology, potentially driven by endo-epicardial asynchrony.
This review highlights the emerging role of focal activation patterns and endo-epicardial asynchrony in the pathophysiology of atrial fibrillation as revealed by high-resolution mapping.
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Focal activation patterns may drive AF via endo-epicardial asynchrony; leaves open therapeutic targeting pending prospective validation.
INTRODUCTION: High-resolution atrial mapping studies have provided novel insights in the pathophysiology of atrial fibrillation (AF) in the last few years. Increasing attention is being drawn to the so-called focal activation patterns (FAPs); however, there is no consensus on criteria to identify and characterize these patterns. Areas covered: In this expert review, an overview of definitions and criteria used to examine FAPs obtained from atrial mapping studies is provided and studies reporting on the underlying mechanisms are discussed. Expert commentary: High-resolution cardiac mapping has revealed the importance of FAPs in the pathophysiology of AF. There is increasing evidence supporting the concept of endo-epicardial (E-E) asynchrony enabling transmural conduction of electrical waves resulting in FAPs. Uniform reports of FAPs in future studies are needed to provide more knowledge on its clinical importance.
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Kharbanda et al. (2018) conducted a review in Atrial fibrillation. High-resolution atrial mapping was evaluated. High-resolution cardiac mapping highlights the importance of focal activation patterns in atrial fibrillation pathophysiology, potentially driven by endo-epicardial asynchrony.
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