Electrophysiological properties in chronic lone atrial fibrillation.

Kumagai, Koji; Akimitsu, Shunsuke; Kawahira, Kozaburo; Kawanami, Fumito; Yamanouchi, Yoshio; Hiroki, Tadayuki; Arakawa, Kikuo

doi:10.1161/01.cir.84.4.1662

Cited by 190 publications

(126 citation statements)

References 38 publications

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“…Kumagai, et al showed that both intraatrial and interatrial conduction lengthened in humans with lone AF after electrocardioversion. 15) Our results confirmed the findings of Kumagai, et al Moreover, the present study also showed that disturbed intraatrial conduction might have some clinical implications. The early recurrence group had lengthened IACT as compared to those with stable sinus rhythm and the control group.…”

Section: Discussionsupporting

confidence: 93%

“…Kumagai, et al showed that both intraatrial and interatrial conduction lengthened in humans with lone AF after electrocardioversion. 15) In the present study, we aimed to measure IACT in patients with chronic AF who were converted to sinus rhythm by direct current cardioversion (CV), compare it with a control group and search for a potential relationship between the early recurrence of AF and conduction properties of atrium.…”

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confidence: 99%

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Lengthening of Intraatrial Conduction Time in Atrial Fibrillation and Its Relation with Early Recurrence of Atrial Fibrillation.

et al. 2001

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SUMMARYIntraatrial conduction delay in atrial fibrillation (AF) that is considered a component of atrial electrical remodeling has been demonstrated previously in experimental models and it is considered an important factor for the induction or stabilization of AF. However, it is not known if this phenomenon exists in human AF. The present study aimed to compare intraatrial conduction time (IACT) in patients with chronic atrial fibrillation who were converted to sinus rhythm and a matched control group, and to investigate its relation with early AF recurrence.Seventeen patients with chronic AF (mean duration of 20.71±16.35 months) were enrolled in the study (7 males, 10 females, 63±8 years). An age and sex matched control group (n=12) consisted of patients with sinus rhythm who underwent electrophysiological study (EPS). None of the patients were on any antiarrhythmic treatment during the procedures. Cardioversion was performed via external DC cardioversion. Eight patients in the control group were delivered a DC shock because of induced ventricular tachycardia during EPS. IACT was defined as the interval between the onset of P wave surface ECG and the beginning of A wave at high right atrium (IACT 1) and low right atrium (IACT 2). Additionally, the interval between A wave at high right atrium and low right atrium was measured (IACT 3).Patient characteristics such as age, sex and echocardiographic variables were not different between the AF group and the control group. Heart rate after cardioversion was found to be similar between the two groups. Total delivered energy was significantly higher in the AF group than in the control group (464.47±165.82 joules vs. 315.00±27.77 joules, p<0.001). IACT 1 (15.30±7.61 msec vs 8.50±5.29 msec, p<0.02 ), IACT 2 (45.25±8.36 msec vs 26. 44±10.45 msec, p<0.001) and IACT 3 (26.9±8.26 msec vs. 18.67±10.05, p<0.05) significantly lengthened in the AF group after maintenance of sinus rhythm compared to the control group. There were 6 early AF recurrences during the 1 week follow-up period. Multivariate analysis, revealed IACT 2 and IACT 3 were significantly different between the control group, the patient with recurred AF and the patients with maintained sinus rhythm. Post-hoc analysis revealed that IACT 2 and IACT 3 significantly lengthened in the patients with recurred AF compared to both the control group

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Section: Discussionsupporting

confidence: 93%

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confidence: 99%

Lengthening of Intraatrial Conduction Time in Atrial Fibrillation and Its Relation with Early Recurrence of Atrial Fibrillation.

et al. 2001

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“…The Nav1.5 α subunit is the principal component of INa channel forming the pore and all essential gating elements, which is sufficient by itself for generating INa in heterologous expression systems. Previous studies showed prolongations of IACT implying slowed atrial conduction in different animal's models (27,28) and patients (29,30) with AF. The slowing of IACT is considered to be one of the most important players for the initiation of reentry in addition to the reduction in AERP and AERP rate adaptation, also the induction of AF.…”

Section: Discussionmentioning

confidence: 94%

Hyperglycemia aggravates atrial interstitial fibrosis, ionic remodeling and vulnerability to atrial fibrillation in diabetic rabbits

Liu

Fu²,

Li³

et al. 2012

Anadolu Kardiyol Derg

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Objective: The purpose of this study was to investigate the effects of hyperglycemia on atrial interstitial fibrosis, ionic remodeling and vulnerability to atrial fibrillation (AF) in alloxan-induced diabetic rabbits. Methods: Sixty Japanese rabbits were randomly assigned to alloxan-induced diabetic group (n=30) and control group (n=30). Ten rabbits in each group were respectively used to electrophysiological and histological study, patch-clamp study and Western blotting analysis. Langendorff perfusion was used to record inter-atrial conduction time (IACT), atrial effective refractory period (AERP) and dispersion (AERPD) and vulnerability to AF. Histological study was measured by Sirius-red stain. Patch-clamp technique was used to measure action potential duration (APD) and atrial ionic currents (INa and ICaL). Western blotting was applied to assess atrial protein expression of transforming growth factor beta 1 (TGFβ1). Results: Compared with control group, electrophysiological studies showed IACT was prolonged (37.91±6.81 vs. 27.43±1.63ms, p<0.01), AERPD was increased (30.37±8.33 vs. 14.70±5.16ms, p<0.01) in diabetic group. Inducibility of AF in diabetic group was significantly higher than in controls (8/10 vs. 1/10 of animals, p<0.01). Collagen volume fraction was increased (6.20±0.64% vs. 2.15±0.21%, p<0.01) in diabetic group. Patch-clamp studies demonstrated APD90 and APD50 were prolonged in diabetic rabbits (p<0.05 vs. control). The densities of INa were reduced and the densities of ICaL were increased (p<0.01 vs. control). Protein expression of TGFβ1 was increased in diabetic group (p<0.001 vs. control). Conclusion: Our study suggests that hyperglycemia contributes to atrial interstitial fibrosis, ionic remodeling and vulnerability to AF in diabetic rabbits, resulting in atrial structural remodeling and electrical remodeling for the development and perpetuation of AF. (Anadolu Kardiyol Derg 2012; 12: 543-50)

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“…[10][11][12][13][14][15][16][17][18][19][20] Despite the observations in the AF patients, this study showed an inter-Vol 48 No 4 esting finding that the MAPD was significantly longer in the higher BNP group, resulting in similar values of the MAPD and its slope in the control patients. Thus, careful interpretation of the elevated BNP levels in this study is needed.…”

Section: Discussion Main Findingsmentioning

confidence: 64%

“…Verifying this relationship may reinforce the explanation for the mechanism of the elevated BNP level in AF patients or provide further insight into the electrophysiology of the human atria in AF. 5,[10][11][12][13][14][15][16][17][18][19][20][21] The present study, therefore, was designed to assess the relationship between the atrial action potential duration (APD), filtered P-wave duration (FPD) measured by the signal-averaged electrocardiogram, and plasma BNP levels in patients with chronic AF who had no history of a heart failure diagnosis or no symptoms suggestive of heart failure at the time of their recruitment.…”

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confidence: 99%

Electrophysiological Properties of the Atrium After Cardioversion of Chronic Atrial Fibrillation Relation to the Plasma Brain Natriuretic Peptide Level

et al. 2007

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Electrophysiological properties in chronic lone atrial fibrillation.

Abstract: These electrophysiological features, which are manifestations of the abnormal atrial electrophysiology, would favor production of atrial reentry in chronic lone AF.

Cited by 190 publications

References 38 publications

Lengthening of Intraatrial Conduction Time in Atrial Fibrillation and Its Relation with Early Recurrence of Atrial Fibrillation.

Lengthening of Intraatrial Conduction Time in Atrial Fibrillation and Its Relation with Early Recurrence of Atrial Fibrillation.

Hyperglycemia aggravates atrial interstitial fibrosis, ionic remodeling and vulnerability to atrial fibrillation in diabetic rabbits

Electrophysiological Properties of the Atrium After Cardioversion of Chronic Atrial Fibrillation Relation to the Plasma Brain Natriuretic Peptide Level

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