Advances in mechanisms of atrial fibrillation: Structural remodeling, high-frequency fractionated electrograms, and reentrant AF drivers

Kevin J. Makati; Alawi A. Alsheikh-Ali; Ann C. Garlitski; Mark S. Link; Munther Homoud; Jonathan Weinstock; N. A M Estes

doi:10.1007/s10840-008-9256-8

Advances in mechanisms of atrial fibrillation: Structural remodeling, high-frequency fractionated electrograms, and reentrant AF drivers

Kevin J. Makati, Alawi A. Alsheikh-Ali, Ann C. Garlitski, Mark S. Link, Munther Homoud, Jonathan Weinstock, N. A M Estes

Research output: Contribution to journal › Review article › peer-review

9 Scopus citations

Abstract

The mechanisms to explain atrial fibrillation (AF) have been widely debated. Although contemporary experimental techniques have provided more insight, hypotheses regarding AF propagation conceived in the early half of the century remain minimally altered and relevant today. Modern mapping technologies have implicated multiwavelet reentry as the electrophysiologic basis to explain AF propagation within the atrial myocardium; however, reentry has also been observed within pulmonary veins and may behave as a focal trigger. The ability to terminate AF by catheter ablation has provided additional clues to explain AF induction and sustenance. The presence of complex fractionated electrograms (CFAE) and subsequent successful CFAE-directed ablation suggest that diseased atrial myocardium is a necessary substrate for AF maintenance. Atrial remodeling creates differential areas of refractory periods and conduction velocity, which, in turn, creates a suitable environment for AF. This review addresses the complex relationship between remodeled atrial myocardium and reentry and explores the role of CFAEs in AF maintenance.

Original language	English (US)
Pages (from-to)	45-49
Number of pages	5
Journal	Journal of Interventional Cardiac Electrophysiology
Volume	23
Issue number	1
DOIs	https://doi.org/10.1007/s10840-008-9256-8
State	Published - Oct 2008

Keywords

Atrial fibrillation
Complex fractionated electrograms
Reentry
Remodeling

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

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10.1007/s10840-008-9256-8

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Advances in mechanisms of atrial fibrillation: Structural remodeling, high-frequency fractionated electrograms, and reentrant AF drivers. / Makati, Kevin J.; Alsheikh-Ali, Alawi A.; Garlitski, Ann C. et al.
In: Journal of Interventional Cardiac Electrophysiology, Vol. 23, No. 1, 10.2008, p. 45-49.

Research output: Contribution to journal › Review article › peer-review

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AU - Homoud, Munther

AU - Weinstock, Jonathan

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Advances in mechanisms of atrial fibrillation: Structural remodeling, high-frequency fractionated electrograms, and reentrant AF drivers

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Keywords

ASJC Scopus subject areas

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