Rotors and the Dynamics of Cardiac Fibrillation
Sandeep V. Pandit,José Jalife +1 more
TLDR
Examination of recent evidence suggesting that rotors are critical in sustaining both atrial and ventricular fibrillation in the human heart and its implications for treatment with radiofrequency ablation is examined.Abstract:
The objective of this article is to present a broad review of the role of cardiac electric rotors and their accompanying spiral waves in the mechanism of cardiac fibrillation. At the outset, we present a brief historical overview regarding reentry and then discuss the basic concepts and terminologies pertaining to rotors and their initiation. Thereafter, the intrinsic properties of rotors and spiral waves, including phase singularities, wavefront curvature, and dominant frequency maps, are discussed. The implications of rotor dynamics for the spatiotemporal organization of fibrillation, independent of the species being studied, are described next. The knowledge gained regarding the role of cardiac structure in the initiation or maintenance of rotors and the ionic bases of spiral waves in the past 2 decades, as well as the significance for drug therapy, is reviewed subsequently. We conclude by examining recent evidence suggesting that rotors are critical in sustaining both atrial and ventricular fibrillation in the human heart and its implications for treatment with radiofrequency ablation.read more
Citations
More filters
Journal ArticleDOI
Mechanisms and Drug Development in Atrial Fibrillation.
TL;DR: The objective is to highlight the magnitude and endemic dimension of AF, which requires a significant effort to develop new and effective antiarrhythmic drugs, but also improve AF prevention and treatment of risk factors that are associated with AF complications.
Journal ArticleDOI
Controversies About Atrial Fibrillation Mechanisms: Aiming for Order in Chaos and Whether it Matters
Stanley Nattel,Dobromir Dobrev +1 more
Journal ArticleDOI
Aberrant sodium influx causes cardiomyopathy and atrial fibrillation in mice
Elaine Wan,Jeffrey Abrams,Richard Weinberg,Alexander Katchman,Joseph Bayne,Sergey Zakharov,Lin Yang,John P. Morrow,Hasan Garan,Steven O. Marx +9 more
TL;DR: Using this model, it is determined that the increase in a persistent sodium current causes heterogeneously prolonged action potential duration and rotors, as well as wave and wavelets in the atria, and thereby mimics mechanistic theories that have been proposed for AF in humans.
Journal ArticleDOI
High-resolution noncontact charge-density mapping of endocardial activation
Andrew A. Grace,Stephan Willems,Christian Meyer,Atul Verma,Patrick M. Heck,Min Zhu,Xinwei Shi,Chou Derrick Ren-Yu,Lam Dang,Christoph Scharf,Gunter Scharf,Graydon E. Beatty +11 more
TL;DR: Global maps of cardiac activation based on CD enable classification of conduction patterns and localized nonpulmonary vein therapeutic targets in atrial fibrillation with confirmed reduction of far-field interference.
Journal ArticleDOI
CrossTalk proposal: Rotors have been demonstrated to drive human atrial fibrillation
TL;DR: The need to improve AF therapy is urgent and requires dramatic advances in mechanistic understanding, and this debate debates this important and clinically relevant topic.
References
More filters
Journal ArticleDOI
Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins
Michel Haïssaguerre,Pierre Jaïs,D. C. Shah,Atsushi Takahashi,Mélèze Hocini,G Quiniou,S. Garrigue,A Le Mouroux,P Le Métayer,Jacques Clementy +9 more
TL;DR: The pulmonary veins are an important source of ectopic beats, initiating frequent paroxysms of atrial fibrillation and these foci respond to treatment with radio-frequency ablation.
Book
Cardiac Electrophysiology : From Cell to Bedside
Douglas P. Zipes,José Jalife +1 more
TL;DR: Part I - Molecular Bases Of Ion Channel Activity PART II - Biophysics and Regulation of Cardiac Ion Channels PART III - Pharmacology of Card cardiac Ion Ch channels PART IV - Cellular Electrophysiology PART V - Models of Cardiopulmonary Excitation PART VI - Neural Control ofCardiac Electrical Activity
Journal ArticleDOI
Excitation-Contraction Coupling and Cardiac Contractile Force.
Donald M. Bers,Yujie Zhu +1 more
TL;DR: The major cellular structures involved in E-C coupling include myofilaments, Na/Ca exchange and the sarcolemmal Ca-pump as mentioned in this paper, as well as the sources and sinks of activator calcium.
Journal ArticleDOI
A dynamic model of the cardiac ventricular action potential. I. Simulations of ionic currents and concentration changes.
Ching-Hsing Luo,Yoram Rudy +1 more
TL;DR: The model provides the basis for the study of arrhythmogenic activity of the single myocyte including afterdepolarizations and triggered activity and can simulate cellular responses under different degrees of Ca2+ overload.
Journal ArticleDOI
A model of the ventricular cardiac action potential. Depolarization, repolarization, and their interaction.
Ching-Hsing Luo,Yoram Rudy +1 more
TL;DR: Simulation of the membrane action potential of the mammalian ventricular cell shows the importance of the slow recovery of INa in determining the response of the cell and relates these phenomena to the underlying ionic channel kinetics.