In search of the sources of cardiac fibrillation

Abstract

Proclivous towards exploring the unknown, I wanted to be an archaeologist as a child. Later, in my teens, I was inclined towards psychology and therefore entered Medical School. However, in 1979 as a second‐year intern in cardiology I discovered my passion: cardiac electrophysiology. I owe that to Jean Francois Warin, then Professor and Head of the arrhythmia services in Bordeaux. The fact that a 12‐lead ECG trace could describe an invisible electrical mechanism operating within the heart fascinated me. I went to Paris to continue working on cardiology with Professor Philippe Coumel. When I returned to Bordeaux in 1982, intracardiac ablation interventions in arrhythmic hearts had just been reported (Gallagher, 1982; Scheinman, 1982). The results seemed magic. We could not only describe and debate a putative mechanism, but also validate it and treat the condition. Our group had the opportunity to perform the initial intracardiac treatment of simple arrhythmias using localized cardiac electrical shocks. This form of energy was quickly replaced by a more convenient and safer form of radiofrequency current. Ten years later, simple tachycardias caused by focal arrhytmogenic factors were being cured successfully in many centres worldwide. After Dr Warin passed away, I moved to the Hopital Cardiologique du Haut‐Leveque under the kind direction of Jacques Clementy, who gave me complete freedom to pursue this complex and developing area of electrophysiology. Once the treatment of most of tachycardias had become routine, we moved towards a new problem: cardiac fibrillations. Fibrillation is the most complex pathology amongst all disorders of cardiac rhythm (Fig 1). » Fibrillation is the most complex pathology amongst all disorders of cardiac rhythm. «Cardiac fibrillation results in rapid and disorganized contraction of the chamber of the heart it affects. Atrial fibrillation (AF), which occurs in the auricles affects 1% of the population …