27. Monophasic Action Potential Recordings in Atrial Fibrillation and Role of Repolarization Alternans

  1. Mohammad Shenasa MD5,
  2. Gerhard Hindricks MD6,
  3. Martin Borggrefe MD7,
  4. Günter Breithardt MD8 and
  5. Mark E. Josephson MD9
  1. Michael R. Franz1,2,
  2. Sameer M. Jamal1,3 and
  3. Sanjiv Narayan4

Published Online: 18 DEC 2012

DOI: 10.1002/9781118481585.ch27

Cardiac Mapping, Fourth Edition

Cardiac Mapping, Fourth Edition

How to Cite

Franz, M. R., Jamal, S. M. and Narayan, S. (2013) Monophasic Action Potential Recordings in Atrial Fibrillation and Role of Repolarization Alternans, in Cardiac Mapping, Fourth Edition (eds M. Shenasa, G. Hindricks, M. Borggrefe, G. Breithardt and M. E. Josephson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118481585.ch27

Editor Information

  1. 5

    Attending Physician, Department of Cardiovascular Services, O'Connor Hospital, Heart & Rhythm Medical Group, San Jose, California, USA

  2. 6

    Professor of Medicine (Cardiology), University Leipzig, Heart Center, Director, Department of Electrophysiology, Leipzig, Germany

  3. 7

    Professor of Medicine (Cardiology), Head, Department of Cardiology, Angiology and Pneumology, University Medical Center, Mannheim Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

  4. 8

    Professor Emeritus of Medicine and Cardiology, Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany

  5. 9

    Chief, Cardiovascular Medicine Division, Director, Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Herman C. Dana Professor of Medicine, Harvard Medical School, Boston, Massachusetts, USA

Author Information

  1. 1

    Veteran Affairs Medical Center, Washington, DC, USA

  2. 2

    Georgetown University Medical Center, Washington, DC, USA

  3. 3

    Washington Hospital Center, Washington, DC, USA

  4. 4

    Veteran Affairs Medical Center and University of California, San Diego, CA, USA

Publication History

  1. Published Online: 18 DEC 2012
  2. Published Print: 10 JAN 2013

ISBN Information

Print ISBN: 9780470670460

Online ISBN: 9781118481585



  • atrial fibrillation;
  • electrical remodeling;
  • monophasic action potential (MAP);
  • action potential duration (APD);
  • electrical restitution curve (ERC);
  • rate maladaptation;
  • action potential duration (APD) alternans;
  • alternans;
  • electrical heterogeneity


Atrial fibrillation (AF) affects millions of people worldwide and is associated with increased rates of death, stroke and other thromboembolic events, heart failure, diminished quality of life, reduced exercise capacity, and left ventricular dysfunction. While mechanisms of AF have been described, the current focus has been to uncover both triggers and substrate. Atrial electrical remodeling is a recognized substrate for the perpetuation of AF. Monophasic action potential (MAP) recordings provide a unique method to investigate localized myocardial depolarization and repolarization, and have been central to descriptions of atrial electrical properties in both physiological and AF states. Electric heterogeneity in AF manifested as rate maladaptation and repolarization alternans is posited to be mechanistically involved in AF development.