Figure 3. Complete rotational circuits at sites of termination of persistent AF.
A) Three cycles of AF in a 66-year-old man, with unipolar electrograms spanning 100% of the AF cycle length (160ms). Dashed line shows the first derivative (-dv/dt), with red vertical lines indicating activation at each AF cycle (maximum –dv/dt). Blue boxes highlight a 50ms window used to detect local activation. Numbered traces on left atrial isochrones (i) show rotational circuits with head-meets-tail interaction. B) Three cycles of AF in a 54-year-old man with persistent AF annotated using blue vertical lines (local peak-to-peak amplitude). Coronary sinus recording confirms AF. (ii) Isochronal activation map shows rotational activation in right atrium.