Action Potential Dynamics in Human Atrial Fibrillation

Abstract

Atrial fibrillation is considered a model disease of trigger and substrate, with atrial electrical remodeling a key substrate factor for perpetuation of AF. Work conducted with human monophasic action potential (MAP) and continuous multipolar recordings has advanced our current understanding of atrial electrical properties and the transitions between physiologic activation of the atria and AF. Electrical heterogeneity seen during AF manifests as rate maladaptation, alternans, and higher-level oscillations in atrial action potential duration and shape. Defining these putative mechanisms for AF have been used to identify novel clinical phenotypes and may be used to guide therapy.