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Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Mapping Atrial Fibrillation: 2015 Update.

Chirag R Barbhayia1, Saurabh Kumar1, Gregory F Michaud1

  • 1Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.

Journal of Atrial Fibrillation
|December 14, 2016
PubMed
Summary
This summary is machine-generated.

Cardiac mapping identifies atrial fibrillation triggers and substrate. Advanced techniques like rotor and fibrosis mapping improve ablation strategies, though multi-modality limitations persist.

Keywords:
Atrial FibrillationCatheter AblationMapping

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Area of Science:

  • Cardiology and Electrophysiology
  • Medical Imaging and Signal Processing

Background:

  • Atrial fibrillation (AF) necessitates identifying triggers and perpetuating substrate for effective ablation.
  • Current activation mapping effectively addresses simple arrhythmias but struggles with complex AF mechanisms like multiple wavelets.

Approach:

  • Investigating rotors as potential AF drivers using various imaging modalities.
  • Utilizing delayed enhancement magnetic resonance imaging (DE-MRI) and electroanatomic mapping to identify atrial fibrosis (substrate).

Key Points:

  • Rotors have been observed in human AF, but ablation targeting them lacks proven benefit.
  • Atrial fibrosis, identified via DE-MRI and electrograms, correlates with poor ablation outcomes.
  • Endocardial and epicardial dissociation may significantly contribute to AF perpetuation.

Conclusions:

  • Multi-modality mapping offers promise for personalized AF ablation strategies.
  • Technological advancements are enhancing AF mapping capabilities and guiding clinical studies.
  • Simultaneous epicardial and endocardial signal recording remains a key limitation for comprehensive mapping.