Biatrial, 3-Dimensional Mapping of Human Atrial Fibrillation: Methodology and Clinical Observations

Citation :Nicholas D. Skadsberg, Rangadham Nagarakanti, Sanjeev Saksena.Biatrial, 3-Dimensional Mapping of Human Atrial Fibrillation: Methodology and Clinical Observations .JAFIB.2009 April;Volume 1 Issue(6): 370-382.

Atrial fibrillation (AF), the most common arrhythmia in clinical practice, accounts for nearly one third of all hospitalizations for cardiac rhythm disturbances. Consequently, this has stimulated intense investigative interest in the development of effective therapeutic options. However, the electrophysiologic (EP) mechanisms of this arrhythmia have been long debated and remain unclear. This has limited the development of effective management strategies. Previous studies have shown the progressive remodeling associated with AF, initially believed to be functional and electrical in nature, now has structural and contractile impact [1]. It is increasingly clear that the latter two processes play an increasingly important role in the recurrence and persistence of AF [2-4]. In an effort to clarify AF mechanisms, numerous experimental models have been developed. Their relationship to human mechanisms remains poorly defined. Direct mapping of human AF has been attempted but is still in its evolution. It is the purpose of this commentary to review existing mapping techniques and propose a new approach for mapping of human AF.
This review describes a new technique for mapping of human atrial fibrillation in the electrophysiologic laboratory on a beat to beat basis. It permits biatrial mapping and high resolution mapping in the atrium of interest. It has been used routinely in clinical practice and clinical observations and experience are presented.