Index
Ep Defined | Getting Started | Working in the EP Lab
Right Atrium | Right Ventricle | Left Atrium | Left Ventricule | Cardiac Conduction | Cardiac Cell Properties | Action Potential | Sympathetic or Not | Med Page
Electrograms Defined | Recording Modes | Electrode Spacing | Filters | EGM Interpretation | Arrhythmia Analysis
The Physical Lab | Tools of the Trade
Setting Up | Catheter Placement | Baseline Measurement | SNRT | Conduction Study | Arrhythmia Induction | Pacing Protocols | Ablation | Tilt Table | Secrets to Success
Bradycardia | Atrial Tach | Atrial Flutter | Atrial Fibrillation | AVNRT | AVRT | Ventricular Tachycardia
Surface ECG's | Intracardiac Questions | Med Challenge | Advanced

Cardiac Arrhythmias - Atrial Fibrillation

Atrial Fib

Atrial Fibrillation

Recording of atrial fibrillation. Note the frequent, chaotic signals visualized on the High Right Atrial and HIS catheters. The HIS Distal channels shows clear higher amplitude ventricular depolarizations with some periodic small, disorganized atrial signals. On the surface ECG, no clear P waves are noted. The next thing to do in this case would be to insert a CS catheter to help visualize what was occurring in the left atrium.

Atrial Fib

Atrial Arrhythmia characterized by atrial depolarizations occuring from 300 to 1000 times per minute. Atrial mechanical contraction is lost and myocardial motion is reduced to a "quivering' motion that is ineffective in pumping blood. This choatic electrical eactivity generates one of the distinctive identifiers of atrial fib, a baseline with no discernable P wave. Condcution through the AV Node is variable resulting in irregular ventricular response. Currently the cause(s) remain unknown though extensive investigation about possible mechanisms is under way.

Atrial Fib - Atrial fibrillation has become one of the most common arrhythmias and has traditionally been one of the more difficult abnormal rhythms to treat. Fibrillation occurs when the atrium starts generating well over 300 signals per minute. The atrium has difficulty in responding to this number of signals and losses its ability to effectively pump blood. It is not fully understood how or why atrial fibrillation occurs, though there are many theories that are currently being explored regarding the origins of atrial fib.

  • Ridge of Marshall

      The Ridge of Marshall is located between the base of the left atrial appendage and the ostium of the left superior pulmonary vein.  This muscular ridge often provides a challenging approach to atrial fib ablations.

 

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