INTRODUCTION AND OBJECTIVES Ectopic activity originating inside the pulmonary veins has been associated with paroxysmal atrial fibrillation in some patients. However, the roles played by the pulmonary veins and the posterior wall of the left atrium in maintaining atrial fibrillation are not well understood. METHODS Our aim was to determine whether there is a correlation between the refractory...

AIMS We describe a new strategic stepwise mapping approach for fast and accurate identification and ablation of ectopic atrial foci using an electroanatomic mapping system. METHODS AND RESULTS Mapping procedures started with the acquisition of four points at the superior/septal part of the tricuspid annulus. According to this activation sequence, maps were continued towards the right atrial f...

Objectives: Atrial fibrilation (AF) develops from an arrhythmogenic ectopic focus, which triggers the vicious circle that creates arrhythmias. Arrhythmogenic foci are often located in transition areas between pulmonary veins and left atrial endothelium. This study aims to compare vein anatomy of patients with without AF using multidetector computed tomographic (MDCT) angiography evaluate relati...

Radiofrequency catheter ablation was performed in 2 patients with atrial tachycardia (AT). In both cases the AT originated from the inferoseptal portion of the right atrium, and the cycle length was 210 ms. The surface ECG demonstrated common counterclockwise atrial flutter, probably caused by functional block in the clockwise direction at the cavo-tricuspid isthmus and posterior right atrium w...

Atrial fibrillation is the most common arrhythmia in humans. The mechanisms underlying its induction and maintenance are not fully understood. However, it seems likely that, similar to sustained ventricular tachyarrhythmias, atrial fibrillation induction and maintenance are related to the presence of an anatomical and/or electrophysiological substrate, activated by specific triggers (ectopic be...

Determining the chamber of origin of focal atrial tachycardias (FATs) arising at or close to the septum might require biatrial mapping. This review focuses on the available tools and methods used to distinguish right atrial from left atrial origin before left atrial access is obtained. These include analysis of P wave morphology, assessing the timing of right atrial septal activation, the seque...

It has been reported that ectopic foci from the pulmonary veins can initiate atrial fibrillation (AF) and can also act as drivers for maintaining AF. However, not all patients with atrial arrhythmias initiate AF. A substrate for atrial propensity to AF is required for AF initiation and maintenance. Thus, we reviewed and discussed mainly the electrophysiological properties observed in AF. Abnorm...

A 60-year-old male with a history of prior ablation of typical cavotricuspid isthmus-dependent atrial flutter presented to us with recurrent palpitations. The surface 12-lead EKG was consistent with atrial tachycardia, for which an ablation was planned. The patient was found to have multiple marcroreentrant left atrial tachycardias utilizing areas of scar as substrate. Isthmuses of tissue with ...

Atrial fibrillation (AF), the most prevalent rhythm disorder in clinical practice, is currently significantly contributing to morbidity and mortality of the ageing population. In the past decades, a tremendous amount of research resulted in valuable insights into AF pathophysiology, with a primary focus on atrial remodeling. Defined as a persistent change in atrial function and structure, remod...

AIMS To characterize the nature and timing of atrial ectopics preceding clinical episodes of paroxysmal atrial fibrillation. METHODS AND RESULTS Holter recordings (n= 177, 60 patients, 58% male, mean age 61.7 +/- 11.5 years) were performed on patients with paroxysmal atrial fibrillation. These were subjected to standard analysis and recordings containing atrial fibrillation episodes suitable ...