The biatrial substrate properties in different types of paroxysmal atrial fibrillation

Shih Yu Huang, Yenn Jiang Lin, Hsuan Ming Tsao, Shih Lin Chang, Li Wei Lo, Hu Feng Hu, Kazuyoshi Suenari, Yung Kuo Lin, Jen Hung Huang, I. Chung Chen, Wen Chin Ko, Eng Thiam Ong, Shih Ann Chen

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Background: The biatrial substrate properties in patients with paroxysmal atrial fibrillation (AF) originating from the pulmonary veins (PVs) and superior vena cava (SVC) are not available. Objective: The purpose of this study is to characterize the differences of biatrial substrate properties in patients with different types of AF. Methods: A total of 36 patients with paroxysmal AF originating from the PV (PV-AF) and 9 patients with paroxysmal AF initiating from the SVC (SVC-AF) were included. Regional electrogram voltage, conduction velocity (CV), and spectral analysis to identify the AF nest were performed to characterize the biatrial, PVs, and SVC substrate. Results: In the left atrial (LA) body, the bipolar voltage, total activation time, CV, and dominant frequency (DF) were similar between the PV-AF and SVC-AF. However, in the PV regions, the electrogram voltage, CV, and DF were decreased in the PV-AF. The proportions of AF nest in the LA body (72.2% vs. 22.2%, P = .008) and PV regions (100% vs. 22.2%, P <.001) were higher in PV-AF compared with SVC-AF, respectively. On the other hand, lower bipolar voltage, longer total activation time, and slower CV of RA body were recognized in the SVC-AF as compared with the PV-AF. In the SVC, lower bipolar voltage, slower CV, higher DF, and higher proportions of AF nest in SVC (16.7% vs. 66.7%, P = .002) were identified in SVC-AF. Conclusion: These most-remodeled substrates in different types of paroxysmal AF indicated the importance of the atrial substrate in the vicinity of the arrhythmogenic thoracic veins. Crown

Original languageEnglish
Pages (from-to)961-967
Number of pages7
JournalHeart Rhythm
Issue number7
Publication statusPublished - Jul 2011
Externally publishedYes


  • Atrial fibrillation
  • Pulmonary vein
  • Substrate mapping
  • Superior vena cava

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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