Current Medical and Technical Concepts in the Analysis of Endocardial Signals in Atrial Fibrillation

Abstract

Atrial fibrillation (AF) is the commonest arrhythmia seen in clinical practice, though our understanding of the mechanisms of its generation, propagation, and reinitiation remains incomplete. This is limiting not only from the scientific point of view, but also from the practical, as regulatory documentation for the treatment of this pathology cannot be developed without an accepted theory. There has been a recent increase in interest in a theory based on the observation that spiral waves, or rotors, with specific properties for each atrium, are the source of the trigger for fibrillation and may therefore serve as targets for radio-frequency treatment in low-invasive endocardial procedures. There is also an approach based in seeking areas of the atrium in which complex fractionated atrial endograms (CFAE) can be recorded. We present here the basic concepts of analysis of atrial signals during atrial fibrillation, reflecting both the technical and medical aspects.