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Updated: Sep 22, 2025
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High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
Published on: July 29, 2011
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Slow Conduction Corridors and Pivot Sites Characterize the Electrical Remodeling in Atrial Fibrillation
Antonio Frontera1, Stefano Pagani2, Luca Rosario Limite1
1Department of Arrhythmology, San Raffaele Hospital, Milan, Italy.
JACC. Clinical Electrophysiology
|May 19, 2022
Summary
Electrical remodeling in atrial fibrillation (AF) involves slow conduction corridors and wave-front curvature. These phenomena, particularly pivot points, may drive re-entrant circuits that sustain AF progression.
Area of Science:
- Electrophysiology
- Cardiology
- Medical Physics
Background:
- Electrical remodeling is a key factor in the progression of atrial fibrillation (AF).
- Understanding the specific electrophysiological phenomena driving AF progression is crucial for developing targeted therapies.
Purpose of the Study:
- To evaluate the progression of electrophysiological phenomena in patients with paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (PsAF).
- To identify specific electrophysiological markers associated with AF progression.
Main Methods:
- High-density electroanatomic mapping during sinus rhythm was performed in 20 AF patients (10 PAF, 10 PsAF) and 5 controls.
- Computational analysis identified slow conduction corridors (<50 cm/s) and pivot points (>2.5 1/s curvature).
Main Results:
- Conduction velocity decreased progressively from controls to PAF to PsAF.
- Slow conduction corridors and pivot points increased with AF progression, clustering near pulmonary vein antra.
- PsAF showed significantly higher wave-front curvature and more pivot points compared to PAF.
Conclusions:
- Electrical remodeling in AF is characterized by slow conduction corridors and increased wave-front curvature.
- Pivot points associated with slow conduction corridors may be critical determinants for re-entrant circuits that maintain AF.
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