Cellular bases for human atrial fibrillation

Workman, Antony J.; Kane, Kathleen A.; Rankin, Andrew C.

doi:10.1016/j.hrthm.2008.01.016

Cited by 70 publications

(91 citation statements)

References 43 publications

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“…In chronic AF, the APD is significantly shorter than in SR due to electrical remodeling [4,25], although there is a substantial overlap in value distributions between the two groups (see Fig. 5).…”

Section: Action Potentialsmentioning

confidence: 99%

Application of the RIMARC algorithm to a large data set of action potentials and clinical parameters for risk prediction of atrial fibrillation

Ravens

Katircioglu-Öztürk

Wettwer

et al. 2014

Med Biol Eng Comput

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learned by the RIMARC algorithm can be used for accurately classifying the preoperative rhythm status. APs were included from 221 SR and 158 AF patients. During a learning phase, the RIMARC algorithm established a ranking order of 62 features by predictive value for SR or AF. The model was then challenged with an additional test set of features from 28 patients in whom rhythm status was blinded. The accuracy of the risk prediction for AF by the model was very good (0.93) when all features were used. Without the seven AP features, accuracy still reached 0.71. In conclusion, we have shown that training the machine-learning algorithm RIMARC with an experimental and clinical data set allows predicting a classification in a test data set with high accuracy. In a clinical setting, this approach may prove useful for finding hypothesis-generating associations between different parameters.Abstract Ex vivo recorded action potentials (APs) in human right atrial tissue from patients in sinus rhythm (SR) or atrial fibrillation (AF) display a characteristic spike-anddome or triangular shape, respectively, but variability is huge within each rhythm group. The aim of our study was to apply the machine-learning algorithm ranking instances by maximizing the area under the ROC curve (RIMARC) to a large data set of 480 APs combined with retrospectively collected general clinical parameters and to test whether the rules Ursula Ravens, Deniz Katircioglu-Öztürk, Ali Oto and H. Altay Güvenir have equally contributed. Action potential duration at 20 % of repolarization (ms) APD 50 Action potential duration at 50 % of repolarization (ms) APD 90 Action potential duration at 90 % of repolarization (ms) dV/dt max Maximum rate of depolarization (Vs −1 ) MAD Maximum area under ROC curve-based discretization PLT 20 "Plateau potential" defined as the mean potential (mV) in the time window between 20 % of APD 90 plus 5 ms RIMARC Ranking instances by maximizing the area under the ROC curve RMP Resting membrane potential (mV) ROC Receiver operating characteristics SR Sinus rhythm Electronic supplementary material

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Section: Action Potentialsmentioning

confidence: 99%

Application of the RIMARC algorithm to a large data set of action potentials and clinical parameters for risk prediction of atrial fibrillation

Ravens

Katircioglu-Öztürk

Wettwer

et al. 2014

Med Biol Eng Comput

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“…23 Rapid atrial activation during atrial fi brillation shortens the action potential and the refractory period of atrial cardiomyocytes, reduces the length of re-entry wave λ and causes electrical heterogeneity. 24 These changes turn into arrhythmia substrate and facilitate its persistence. This makes the arrhythmia itself a major provoking moment for its persistence.…”

Section: Discussionmentioning

confidence: 99%

Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

Negreva

Penev²

2012

Folia Medica

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The incidence of atrial fi brillation has been rapidly increasing in recent years. The increased tonus of the sympathetic nervous system is related to the development of atrial fi brillation. OBJECTIVE: To study the effect of bisoprolol, a highly selective beta-blocker, on patients with recent-onset atrial fi brillation (< 48 hours) for regularization of the rhythm using propafenone. PATIENTS AND METHODS: The study includes 164 patients (81 women, 83 men, age 59.09 ± 10.81) with successfully restored sinus rhythm in recent-onset atrial fi brillation. The patients received either propafenone (group A, n = 82) or a combination of propafenone and bisoprolol (group B, n = 82). The studied patients were randomly allocated to the groups. Propafenone was administered intravenously as a 2 mg/kg bolus followed by infusion of 0.0078 mg/kg/min for 120 min and orally in dosage of 300 mg three times every 8 hours if arrhythmia persisted. Bisoprolol was administered in a single dose at the very beginning of propafenone treatment and only in patients from group B at a dose of 5 or 10 mg. Regularization of the rhythm was assessed at the 3rd, 6th, 12th and 24th hour. RESULTS: In the initial stages of regularization the combined therapy restored the sinus rhythm in a greater number of patients in comparison with the monotherapy (at the 6th hour 67.07% in group B versus 48.78% in group A, P < 0.05; at the 12th hour it was 87.80% versus 75.60%, respectively, P < 0.05). CONCLUSION: Early regularization of rhythm in patients with recent-onset atrial fi brillation reduces the likelihood of recurrent episodes of arrhythmia. This makes the application of selective beta-blockade clinically signifi cant.

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“…3 Chronic ventricular tachypacing (VTP) models of HF-induced AF have been shown in numerous studies to cause atrial structural and electrophysiological remodelling, with a variety of changes in ion currents, action potentials (APs), and intracellular Ca 2+ (Ca 2+ i ) handling. For example, AP duration (APD) is either increased, 4,5 unchanged, 6 or shortened; 7 the Ca 2+ i -transient amplitude is increased 5 (in contrast with a decrease, in the ventricle), 8 and delayed afterdepolarizations (DADs) also occur.…”

Section: Introductionmentioning

confidence: 99%

Chronic myocardial infarction promotes atrial action potential alternans, afterdepolarisations and fibrillation

Kettlewell

Burton

Smith

et al. 2013

Journal of Electrocardiology

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Cellular bases for human atrial fibrillation

Cited by 70 publications

References 43 publications

Application of the RIMARC algorithm to a large data set of action potentials and clinical parameters for risk prediction of atrial fibrillation

Application of the RIMARC algorithm to a large data set of action potentials and clinical parameters for risk prediction of atrial fibrillation

Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

Chronic myocardial infarction promotes atrial action potential alternans, afterdepolarisations and fibrillation

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