Atrial Contractile Dysfunction After Short-term Atrial Fibrillation Is Reduced by Verapamil but Increased by BAY K8644

Leistad, E.; Aksnes, Gunnar; Verburg, Esther; Christensen, Geir

doi:10.1161/01.cir.93.9.1747

Cited by 132 publications

(73 citation statements)

References 48 publications

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“…Maneuvers increasing intracellular calcium (pacing, isoproterenol, and calcium) improved atrial mechanical dysfunction, suggesting an actual or relative intracellular calcium deficiency to be responsible for the observed atrial mechanical dysfunction. Previous studies have demonstrated atrial arrhythmias to result in altered calcium handling 22 and intracellular calcium accumulation, 23 perhaps implicating a supranormal intracellular calcium level for the observed effects. However, evidence suggests that homeostatic mechanisms act to reduce the accumulating intracellular calcium by a decrease of the L-type calcium current.…”

Section: Implications For the Mechanism Of Atrial Mechanical Remodelimentioning

confidence: 96%

Reversal of Atrial Mechanical Stunning After Cardioversion of Atrial Arrhythmias

et al. 2002

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Background-Atrial mechanical stunning develops on termination of chronic atrial arrhythmias and is implicated in the genesis of thromboembolic complications after cardioversion. The mechanisms responsible for atrial mechanical stunning are unknown. The effects of atrial rate, isoproterenol, and calcium on atrial mechanical function in patients with atrial stunning have not been evaluated, and it is not known if atrial stunning can be reversed. Methods and Results-Thirty-five patients with chronic atrial flutter (AFL) undergoing radiofrequency ablation were studied. Fifteen patients in sinus rhythm undergoing ablation for paroxysmal AFL were studied as control for effects of the procedure. Left atrial appendage emptying velocities (LAAEVs) and spontaneous echocardiographic contrast (LASEC) were assessed by transesophageal echocardiography during AFL, after reversion to sinus rhythm, during atrial pacing at cycle lengths of 750 to 250 ms, after a postpacing pause, and with isoproterenol or calcium. PϽ0.0001). No change in LAAEV was observed in the paroxysmal AFL group. Conclusion-Atrial mechanical stunning can be reversed by pacing at increased rates and through the administration of isoproterenol or calcium. These findings suggest a functional contractile apparatus in the mechanically remodeled atrium as a result of chronic atrial flutter.

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Section: Implications For the Mechanism Of Atrial Mechanical Remodelimentioning

confidence: 96%

Reversal of Atrial Mechanical Stunning After Cardioversion of Atrial Arrhythmias

et al. 2002

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“…Frequent [17][18][19] and irregular 20 depolarization of atrial myocytes during AF results in elevation of cytosolic calcium. 9 The absence of AF-induced contractile dysfunction in patients pretreated with verapamil suggests that AF-induced cytosolic calcium overload may mediate this acute dysfunction.…”

Section: Possible Mechanismsmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] A study of pacing-induced AF in pigs demonstrated that a brief episode of AF induces acute atrial contractile dysfunction and that this can be blunted by verapamil. 9 However, no prior studies have assessed the short-term effect of a brief episode of AF on left atrial contractility in humans or the effect of pretreatment with verapamil. Therefore, the purpose of this study was to measure the effect of pacing-induced AF on the LAA emptying velocity in patients and to determine whether verapamil modifies this effect.…”

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confidence: 99%

Short-Term Effect of Atrial Fibrillation on Atrial Contractile Function in Humans

et al. 1999

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Background-Conversion of chronic atrial fibrillation (AF) is associated with atrial stunning, but the short-term effect of a brief episode of AF on left atrial appendage (LAA) emptying velocity is unknown. The purpose of this study was to determine whether a short episode of AF affects left atrial function and whether verapamil modifies this effect. Methods and Results-The subjects of this study were 19 patients without structural heart disease undergoing an electrophysiology procedure. In 13 patients, LAA emptying velocity was measured by transesophageal echocardiography in the setting of pharmacological autonomic blockade before, during, and after a short episode of AF. During sinus rhythm, the baseline LAA emptying velocity was measured 5 times and averaged. AF was then induced by rapid right atrial pacing. After either spontaneous or electrical conversion, LAA emptying velocity was measured immediately on resumption of sinus rhythm and every minute thereafter. The mean duration of AF was 15.3Ϯ3.8 minutes. The mean baseline emptying velocity was 70Ϯ20 cm/s. The first post-AF emptying velocity was 63Ϯ20 cm/s (Pϭ0.02 versus baseline emptying velocity). The post-AF emptying velocity returned to the baseline emptying velocity value after 3.0 minutes. The mean percent reduction in post-AF emptying velocity was 9.7Ϯ21% (range, 15% increase to 56% decrease). A second group of 6 patients were pretreated with verapamil (0.1-mg/kg IV bolus followed by an infusion of 0.005 mg ⅐ kg Ϫ1 ⅐ min

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“…While ionic remodeling (3)(4)(5) as well as changes in cellular and structural architecture (6) have been described, increasing evidence for a role of perturbations in energetic metabolism exists. In fact, various studies have shown modifications in energetic metabolism in both animal models (7)(8)(9)(10)(11) and humans (12)(13)(14) and after both chronic or short episodes of AF (9,10,(12)(13)(14). However, a variety of changes have been observed.…”

Section: Introductionmentioning

confidence: 99%

Energetic metabolism during acute stretch-related atrial fibrillation

et al. 2008

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Background and methods-Perturbations in energetic metabolism and impaired atrial contractility may play an important role in the pathogenesis of atrial fibrillation (AF). Besides, atrial stretch is commonly associated with AF. However, the atrial energetics of stretch-related AF are poorly understood. Here, we measured indicators of energy metabolism during acute-stretch related AF. PCr, adenine nucleotides and derivatives concentrations as well as the activity of the F 0 F 1 -ATPase and Na,K-ATPase were obtained after one hour of stretch and/or AF in isolated rabbit hearts and compared to control hearts without stretch and AF.

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Atrial Contractile Dysfunction After Short-term Atrial Fibrillation Is Reduced by Verapamil but Increased by BAY K8644

Cited by 132 publications

References 48 publications

Reversal of Atrial Mechanical Stunning After Cardioversion of Atrial Arrhythmias

Reversal of Atrial Mechanical Stunning After Cardioversion of Atrial Arrhythmias

Short-Term Effect of Atrial Fibrillation on Atrial Contractile Function in Humans

Energetic metabolism during acute stretch-related atrial fibrillation

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