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
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2017 HRS / EHRA / ECAS / APHRS / SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation
Hugh Calkins,Gerhard Hindricks,Riccardo Cappato,Young Hoon Kim,Eduardo B. Saad,Luis Aguinaga,Joseph G. Akar,Vinay Badhwar,Josep Brugada,John Camm,Peng Sheng Chen,Shih Ann Chen,Mina K. Chung,Jens Cosedis Nielsen,Anne B. Curtis,D. Wyn Davies,John D. Day,Andre d'Avila,N. M. S. de Groot,Luigi Di Biase,Mattias Duytschaever,James R. Edgerton,Kenneth A. Ellenbogen,Patrick T. Ellinor,Sabine Ernst,Guilherme Fenelon,Edward P. Gerstenfeld,David E. Haines,Michel Haïssaguerre,Robert H. Helm,Elaine M. Hylek,Warren M. Jackman,José Jalife,José Jalife,Jonathan M. Kalman,Josef Kautzner,Hans Kottkamp,Karl Heinz Kuck,Koichiro Kumagai,Richard Lee,Thorsten Lewalter,Bruce D. Lindsay,Laurent Macle,Moussa Mansour,Francis E. Marchlinski,Gregory F. Michaud,Hiroshi Nakagawa,Andrea Natale,Stanley Nattel,Ken Okumura,Douglas L. Packer,Evgeny Pokushalov,Matthew R. Reynolds,Prashanthan Sanders,Mauricio Scanavacca,Richard J. Schilling,Claudio Tondo,Hsuan Ming Tsao,Atul Verma,David J. Wilber,Teiichi Yamane +60 more
TL;DR: This 2017 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a writing group, convened by these five international societies.
Journal ArticleDOI
2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society
Sana M. Al-Khatib,William G. Stevenson,Michael J. Ackerman,William J. Bryant,David J. Callans,Anne B. Curtis,Barbara J. Deal,Timm Dickfeld,Michael E. Field,Gregg C. Fonarow,Anne M. Gillis,Christopher B. Granger,Stephen C. Hammill,Mark A. Hlatky,Jose A. Joglar,G. Neal Kay,Daniel D. Matlock,Robert J. Myerburg,Richard L. Page +18 more
TL;DR: The next chair and vice-chair will be announced at a special meeting of the American Academy of Anti-Accident and Accident Medicine (AACC) board of directors in New York later this month.
Journal ArticleDOI
EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: Definition, characterization, and clinical implication
Andreas Goette,Jonathan M. Kalman,Luis Aguinaga,Joseph G. Akar,José Angel Cabrera,Shih Ann Chen,Sumeet S. Chugh,Domenico Corradi,Andre d'Avila,Dobromir Dobrev,Guilherme Fenelon,Mario D. Gonzalez,Stéphane N. Hatem,Robert H. Helm,Gerhard Hindricks,Siew Yen Ho,Brian Hoit,José Jalife,Young Hoon Kim,Gregory Y.H. Lip,Chang Sheng Ma,Gregory M. Marcus,Katherine T. Murray,Akihiko Nogami,Prashanthan Sanders,William Uribe,David R. Van Wagoner,Stanley Nattel,Stanley Nattel +28 more
TL;DR: The working group proposes the following working definition of atrial cardiomyopathy: ‘Any complex of structural, architectural, contractile or electrophysiological changes affecting the atria with the potential to produce clinically-relevant manifestations’ (Table 1).
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Role of the Autonomic Nervous System in Atrial Fibrillation: Pathophysiology and Therapy
TL;DR: In this article, the authors focus on the relationship between the autonomic nervous system and the pathophysiology of atrial fibrillation and the potential benefit and limitations of neuromodulation in the management of this arrhythmia.
Journal ArticleDOI
2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death
Sana M. Al-Khatib,William G. Stevenson,Michael J. Ackerman,William J. Bryant,David J. Callans,Anne B. Curtis,Barbara J. Deal,Timm Dickfeld,Michael E. Field,Gregg C. Fonarow,Anne M. Gillis,Christopher B. Granger,Stephen C. Hammill,Mark A. Hlatky,Jose A. Joglar,G. Neal Kay,Daniel D. Matlock,Robert J. Myerburg,Richard L. Page +18 more
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James N. Weiss,Zhilin Qu,Peng Sheng Chen,Shien-Fong Lin,Hrayr S. Karagueuzian,Hideki Hayashi,Alan Garfinkel,Alain Karma +7 more
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Presence of Left-to-Right Atrial Frequency Gradient in Paroxysmal but Not Persistent Atrial Fibrillation in Humans
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Journal Article
Spectral Analysis Identifies Sites of High-Frequency Activity Maintaining Atrial Fibrillation in Humans
PrashanthanSanders,OmerBerenfeld,MélèzeHocini,PierreJaïs,RaviVaidyanathan,Li-FernHsu,StéphaneGarrigue,YoshihideTakahashi,MartinRotter,FrédericSacher,ChristopheScavée,RobertPloutz-Snyder,JoséJalife,MichelHaïssaguerre +13 more
TL;DR: The effect of ablation at sites with or without high-frequency DF sites (maximal frequencies surrounded by a decreasing frequency gradient ≥20%) was evaluated by determining the change in AF cycle length (AFCL) and the termination and inducibility of AF.
Journal ArticleDOI
A Mathematical Model of Action Potential Heterogeneity in Adult Rat Left Ventricular Myocytes
TL;DR: Simulation results support the hypothesis that the smaller density and the slower reactivation kinetics of the Ca(2+)-independent transient outward K(+) current (I(t)) in the endocardial myocytes can account for the longer action potential duration (APD), and more prominent rate dependence in that cell type.
Journal ArticleDOI
Rectification of the background potassium current: A determinant of rotor dynamics in ventricular fibrillation
Faramarz H. Samie,Omer Berenfeld,Justus M.B. Anumonwo,Sergey Mironov,Sharda Udassi,Jacques Beaumont,Steven M. Taffet,Arkady M. Pertsov,José Jalife +8 more
TL;DR: This study provides new evidence in the isolated guinea pig heart that a persistent high-frequency rotor in the LV maintains VF, and that spatially distributed gradients in IK1 density represent a robust ionic mechanism for rotor stabilization and wavefront fragmentation.