This human case is the first to illustrate morphological manifestations of direction- and rate-dependent anisotropic conduction in high-resolution unipolar atrial potentials. Premature impulses induced low-amplitude, fractionated extracellular potentials with exceptionally prolonged durations in a 76-year old longstanding persistent patient with atrial fibrillation (AF), demonstrating direction-dependency of anisotropic conduction. An increased pacing frequency induced presence of similar fractionated potentials, reflecting rate-dependent anisotropy and inhomogeneous, slow conduction. Pacing with different rates and from different sites could aid in identifying nonuniform anisotropic tissue and thus the substrate of AF.

Additional Metadata
Keywords anisotropy, atrial fibrillation, direction-dependency, fractionation, rate-dependency, surgical ablation
Persistent URL dx.doi.org/10.1111/jce.14597, hdl.handle.net/1765/127853
Journal Journal of Cardiovascular Electrophysiology
Citation
Starreveld, R. (Roeliene), & de Groot, N.M.S. (2020). Direction- and rate-dependent fractionation during atrial fibrillation persistence: Unmasking cardiac anisotropy?. Journal of Cardiovascular Electrophysiology. doi:10.1111/jce.14597