Challenges Associated with Interpreting Mechanisms of AF

Arrhythmia & Electrophysiology Review
Caroline H RoneyNicholas S. Peters

Abstract

Determining optimal treatment strategies for complex arrhythmogenesis in AF is confounded by the lack of consensus regarding the mechanisms causing AF. Studies report different mechanisms for AF, ranging from hierarchical drivers to anarchical multiple activation wavelets. Differences in the assessment of AF mechanisms are likely due to AF being recorded across diverse models using different investigational tools, spatial scales and clinical populations. The authors review different AF mechanisms, including anatomical and functional re-entry, hierarchical drivers and anarchical multiple wavelets. They then describe different cardiac mapping techniques and analysis tools, including activation mapping, phase mapping and fibrosis identification. They explain and review different data challenges, including differences between recording devices in spatial and temporal resolutions, spatial coverage and recording surface, and report clinical outcomes using different data modalities. They suggest future research directions for investigating the mechanisms underlying human AF.

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Citations

Apr 25, 2020·International Journal of Molecular Sciences·Narcis TribulovaBarbara Szeiffova Bacova
Jul 24, 2021·JACC. Clinical Electrophysiology·Ravi MandapatiRahul Bhardwaj

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Methods Mentioned

BETA
imaging techniques

Clinical Trials Mentioned

NCT02529319

Software Mentioned

AcQMap
focal impulse and rotor modulation ( FIRM )
RETRO
Mapping

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