Non-invasive, high-density mapping of human atrial fibrillation - introduction and illustration of a novel diagnostic tool

Electrical atrial activation during atrial fibrillation shows an uncoordinated pattern. Invasive studies and computer models have shown that functional and anatomical barriers can sustain atrial fibrillation. Mechanisms involved in the fibrillatory process are multiple wave reentry, rotors and spiral waves. We have developed a new diagnostic tool with the aim to characterize electrical activation patterns during atrial fibrillation from the body surface. Non-invasive high density mapping using 56 surface electrodes placed on the chest and back of six patients with persistent atrial fibrillation was performed. For the first time, we observed different activation patterns of atrial fibrillation from the body surface: single or multiple wavefronts with different degrees of repeatability. Further study of the activation patterns could be useful in the diagnosis and individual selection of the best treatment with atrial fibrillation.