Temporal Stability of Rotors and Atrial Activation Patterns in Persistent Human Atrial Fibrillation
A High-Density Epicardial Mapping Study of Prolonged Recordings
Tomos E. Walters, Geoffrey Lee, Gwilym Morris, Steven Spence, Marco Larobina, Victoria Atkinson, Phillip Antippa, John Goldblatt, Alistair Royse, Michael O’Keefe, Prashanthan Sanders, Joseph B. Morton, Peter M. Kistler and Jonathan M. Kalman
(A) Bipolar electrograms (EGMs) taken from 8 locations around the path of the rotor, encircling the rotor core, over 2 s. (B) EGMs over 500 ms, mapping the entire circuit. (C) Color-encoded map of the mean cycle length (CL) at each electrode location. There is clockwise rotation around a region of short CL activity in the center of the left atrial posterior wall (LAPW). (D) Example activation map of a single cycle of the clockwise rotor. (E) EGMs recorded over 5 s from the right atrial (RA) free wall, simultaneous with the LAPW recordings in A and B, confirming fibrillatory activation.