COMMON CARDIAC ARRHYTHMIAS 2 the complex arrhythmias Mark Earley, St Bartholomew’s Hospital.

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Presentation transcript:

COMMON CARDIAC ARRHYTHMIAS 2 the complex arrhythmias Mark Earley, St Bartholomew’s Hospital

Atrial Fibrillation (AF)

Paroxysmal AF

AF – modern terminology FIRST EPISODE of AF RECURRENT EPISODE of AF PAROXYSMAL AF PERSISTENT AF PERMANENT AFSINUS RHYTHM

AF - aetiology

AF – mechanism - chaos

Mechanism of AF: focal v re-entry FOCALRE-ENTRY (Circus movement) Moe’s Hypothesis multiple random re-entry wavefronts

Mechanism - focal Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. NEJM 1998; 339:659-66

Mechanism of AF Focal ‘triggers’ Multiple wavefronts

Mechanism of AF PAROXYSMAL PERSISTENT PERMANENT

Preexcited AF