Patients with longstanding persistent atrial fibrillation and structural heart disease
Patients with acute atrial fibrillation
Frequency of epicardial breakthroughssurrogate
Increased frequency of epicardial breakthroughs provides a mechanistic explanation for the high persistence of atrial fibrillation in patients with structural heart disease.
Focal fibrillation waves are due to epicardial breakthrough of waves propagating in deeper layers of the atrial wall. In patients with longstanding AF, the frequency of epicardial breakthroughs was 4 times higher than during acute AF. Because they provide a constant source of independent fibrillation waves originating over the entire epicardial surface, they offer an adequate explanation for the high persistence of AF in patients with structural heart disease.
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Natasja M.S. de Groot
Electrophysiology
Richard Houben
Karolinska University Hospital
Joep L.R.M. Smeets
Radboud University Nijmegen
Circulation
Erasmus MC
Leiden University Medical Center
Medtronic (United States)
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Groot et al. (Tue,) studied this question.
synapsesocial.com/papers/69d56df475589c71d767d21f — DOI: https://doi.org/10.1161/circulationaha.109.910901