Non invasive mapping of human atrial fibrillation

Abstract

Invasive high-density mapping of atrial fibrillation (AF) has revealed different patterns of atrial activation ranging from single wavefronts to disorganized activation with multiple simultaneous wavefronts. Whether or not similar activation patterns can also be observed using body surface recordings is currently unknown, and was consequently evaluated in this study. Surface electrocardiographic mapping was performed in 14 patients with persistent AF. A total of fifty six electrocardiographic leads were placed on the chest over the atria on the front (n=40) and on the back (n=16). Isochrone maps reflecting wavefront propagation were automatically computed and visually classified as either type I (single wavefront), II (single wavefront with wave breakages and splitting) or III (multiple simultaneous wavefronts). Almost half of the patients (N=6) presented most predominantly type III atrial activation while 6 patients mostly presented type I activation. The rest of the patients (N=2) presented mixed type I and type III activations. All observed non invasive patterns were consistent with the invasive patterns previously described by Konings.