@article{oai:niigata-u.repo.nii.ac.jp:00006404,
 author = {Niwano, Shinichi and Ma, Meilei and Furushima, Hiroshi and Ohira, Koji and Chinushi, Masaomi and Aizawa, Yoshifusa},
 issue = {2},
 journal = {Acta medica et biologica, Acta medica et biologica},
 month = {Jun},
 note = {The sites of atrial fibrillation genesis and electrophysiological parameters of the atria were evaluated in 24 patients with Wolff-Parkinson-White (WPW) syndrome with induced atrial fibrillation in an electrophysiologic study. The twenty-four patients, 8 females and 16 males had a mean age of 42± 16 years. Atrial electrogram was recorded at three atrial sites during the initiation of atrial fibrillation: the high right atrium (HRA), the His bundle electrogram recording site (HBE), and the coronary sinus (CS). The site of atrial fibrillation genesis was determined as the recording site that first showed fragmented atrial electrogram at the time atrial fibrillation occurred. Atrial fibrillation was generated from the HRA site in 15/24 patients, the HBE site in 6/24 patients, and the CS site in 3 patients. Atrial effective refractory period (AERP), atrial wave duration at the HRA site (A1), prolongation of atrial wave during premature beat at the HRA site (%A2/A1), prolongation of atrial wave duration at the CS site during retrograde excitation of the atrium (% Cret/Cant), antegrade and retrograde effective refractory period of the accessory pathway (Kant-ERP, KretERP), and wavelength index (WLI) were evaluated in each patient. Only the %A2/A1 and WLI were significantly different among the groups with different sites of atrial fibrillation genesis. Atrial vulnerability of the HRA site was highest in patients with HRA genesis of atrial fibrillation as represented by the largest %A2/A1 and shortest WLI at the HRA recording site. Although different types of atrial fibrillation might occur, the HRA site is considered to play an important role in initiating atrial fibrillation in patients with WPW syndrome.},
 pages = {51--62},
 title = {The Mechanism of Atrial Fibrillation in Patients with Wolff-Parkinson-White Syndrome : Importance of Atrial Vulnerability in the Right Atrium},
 volume = {45},
 year = {1997}
}