The left atrial appendage (LAA) has recently been recognized as a potential source of arrhythmia in patients undergoing repeat ablation procedures for atrial fibrillation (AF). In this case report we describe sustained fibrillation contained entirely within the LAA, that continued even after electrical isolation of the LAA was performed. This case supports the concept that in selected patients ...

Atrial fibrillation (AF) is leading cardiac arrhythmia with important clinical implications. Its diagnosis is usually made on the basis on 12-lead ECG or 24-hour Holter monitoring. More and more clinical evidence supports diagnostic use of cardiac event recorders and cardiovascular implantable electronic devices (CIED). Treatment options in patients with atrial fibrillation are extensive and ar...

BACKGROUND Atrial fibrillation (AF) is the most common heart rhythm disorder in adults. Currently, use of the circumferential pulmonary vein isolation (CPVI) technique is the cornerstone of ablation therapy for paroxysmal atrial fibrillation. In this report, we described our ablation strategy and outcomes when treating a limited number of AF patients. METHODS This study enrolled patients with...

The cycle length (CL) of atrial fibrillation (AF) may have clinical utility, yet reliable CL measurements typically require invasive electrophysiologic study (EPS). We hypothesized that autocorrelation analysis of the ECG accurately reflects intra-atrial CL in AF, and is more robust than spectral analysis from QRS-subtracted ECGs. Methods We studied 39 patients undergoing AF ablation. For ECG l...

AIMS Patients with asymptomatic and undiagnosed atrial fibrillation (AF) are at increased risk of heart failure and ischaemic stroke. In this study, we validated a new diagnostic device, the MyDiagnostick, for detection of AF by general practitioners and patients. It records and stores a Lead I electrocardiogram (ECG) which is automatically analysed for the presence of AF. METHODS AND RESULTS...

The advent of technology for the delivery of radiofrequency energy via electrode catheters, in the late 1980s, led to the perfection of techniques for the ablation of accessory pathways and classical flutter [1e4]. This has been so successful that these substrates for arrhythmia are rarely seen in the Western world. Two major arrhythmias, however, still remain to be conquereddatrial fibrillatio...

OBJECTIVE Since short action potentials and short refractory periods facilitate the induction of atrial reentry, this maladaptation has been proposed as the pathophysiological basis of the frequent immediate recurrences of atrial fibrillation (IRAF) after internal cardioversion. However, short-term reverse electrophysiological changes of the atria after cardioversion have not been studied in hu...

Maintenance of atrial fibrillation is a complex mechanism, including extensive electrical and structural remodeling of the atria which involves progressive fibrogenesis. Galectin-3 is a biomarker of fibrosis, and, thus, may be involved in atrial remodeling in atrial fibrillation patients. We review the role of galectin-3 in AF mechanisms and its potential therapeutic implications.

Objective: To create a risk score using clinical factors to determine whom to screen and monitor for atrial fibrillation (AF). Patients and Methods: The AF risk score was developed based on the summed odds ratios (ORs) for AF development of 7 accepted clinical risk factors. The AF risk score is intended to assess the risk of AF similar to how the CHA2DS2-VASc score assesses stroke risk. Seven v...

This review highlights the role of atrial monophasic action potential duration (APD) in understanding atrial electrical properties in paroxysmal, persistent, and permanent atrial fibrillation (AF) states. Alternans of APD and rate maladaptation in a spatially divergent way appear mechanistically involved in AF initiation, development, and persistence. The underlying pathophysiology warrants fur...