Synergistic Action of Atrial Dilation and Sodium Channel Blockade on Conduction in Rabbit Atria

Eijsbouts, Sabine; Houben, Richard; Blaauw, Yuri; Schotten, Ulrich; Allessie, Maurits A.

doi:10.1046/j.1540-8167.2004.04326.x

Cited by 40 publications

(31 citation statements)

References 31 publications

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“…The explanation could be that the basic conductance is for Na + when SACs are activated [21,32], and that a relatively less negative resting membrane potential [13] leads to markedly larger effects of sodium channels blockade and post-repolarization refractoriness. Thus, our data suggest that the effect of sodium channels blockade is strongly enhanced upon acute atrial stretch, confirming a recent experimental report [17].…”

Section: Flecainide Groupsupporting

confidence: 93%

“…Also, Zarse et al [16] investigated the effects of verapamil, glibenclamide and cariporide, and concluded that calcium overload plays a crucial role in short-term electrophysiological changes caused by atrial dilatation, as opposed to atrial ischemia or acidosis which have no significant impact. Finally, Eijsbouts et al [17] recently showed that the effects of flecainide on atrial refractoriness were enhanced by acute atrial stretch. With the same model of acute stretch-related AF, we perfused BRL-32872, dofetilide and flecainide after 30 min of sustained AF.…”

Section: Discussionmentioning

confidence: 98%

“…In this work, verapamil prevented the shortening of atrial refractory periods, whereas glibenclamide and cariporide did not have any effects. Inversely, Eijsbouts et al [17] recently showed that the effects of flecainide on atrial refractoriness were enhanced by acute atrial stretch. Nevertheless, the comparison of several classes of antiarrhythmic drugs has not been completely evaluated.…”

Section: Introductionmentioning

confidence: 99%

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Anti-arrhythmic Effects of I Na, I Kr, and Combined I Kr–I CaL Blockade in an Experimental Model of Acute Stretch-Related Atrial Fibrillation

Kalifa

Bernard

Gout

et al. 2007

Cardiovasc Drugs Ther

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Section: Flecainide Groupsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Anti-arrhythmic Effects of I Na, I Kr, and Combined I Kr–I CaL Blockade in an Experimental Model of Acute Stretch-Related Atrial Fibrillation

Kalifa

Bernard

Gout

et al. 2007

Cardiovasc Drugs Ther

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show abstract

“…In the RA, they were predominantly orientated parallel to the large pectinate muscles. Also, in other studies, 7,22,23 lines of block were found along the long axis of the crista terminalis and large pectinate muscles. In the posterior LA wave boundaries were predominantly oriented in a craniocaudal direction.…”

Section: 'Cracks In the Atrial Wall'mentioning

confidence: 58%

Electropathological Substrate of Long-Standing Persistent Atrial Fibrillation in Patients With Structural Heart Disease

Allessie

Groot

Houben

et al. 2010

Circ: Arrhythmia and Electrophysiology

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380

302

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Background-The electropathological substrate of persistent atrial fibrillation (AF) in humans is largely unknown. The aim of this study was to compare the spatiotemporal characteristics of the fibrillatory process in patients with normal sinus rhythm and long-standing persistent AF. Methods and Results-During cardiac surgery, epicardial mapping (244 electrodes) of the right atrium (RA), the left lateral wall (LA), and the posterior left atrium (PV) was performed in 24 patients with long-standing persistent AF. Twenty-five patients with normal sinus rhythm, in whom AF was induced by rapid pacing, served as a reference group. A mapping algorithm was developed that separated the complex fibrillation process into its individual elements (wave mapping). Parameters used to characterize the substrate of AF were (1) the total length of interwave conduction block, (2) the number of fibrillation waves, and (3) the ratio of block to collision of fibrillation waves (dissociation index). In 4403 maps of persistent AF, no evidence for the presence of stable foci or rotors was found. Instead, many narrow wavelets propagated simultaneously through the atrial wall. The lateral boundaries of these waves were formed by lines of interwave conduction block, predominantly oriented parallel to the atrial musculature. Lines of block were not fixed but continuously changed on a beat-to-beat basis. In patients with persistent AF, the total length of block in the RA was more than 6-fold higher than during acute AF (median, 21.1 versus 3.4 mm/cm 2 ; PϽ0.0001). The highest degree of interwave conduction block was found in the PV area (33.0 mm/cm 2 ). The number of fibrillation waves during persistent AF was 4.5/cm 2 compared with 2.3 during acute AF, and the dissociation index was 7.3 versus 1.5 (PϽ0.0001). The interindividual variation of these parameters among patients was high. Conclusions-Electric dissociation of neighboring atrial muscle bundles is a key element in the development of the substrate of human AF. The degree of the pathological changes can be measured on an individual basis by electrophysiological parameters in the spatial domain. (Circ Arrhythm Electrophysiol. 2010;3:606-615.)

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“…10,11 Local conduction velocity was calculated as the mean of two conduction vectors in a 2.5-mm ϫ 2.5-mm area. Slow conduction was defined as local conduction velocities between 10 and 20 cm/s.…”

Section: Regional Conduction: Conduction Slowing and Conduction Blockmentioning

confidence: 99%

The role of chronic atrial stretch and atrial fibrillation on posterior left atrial wall conduction

Roberts‐Thomson¹,

Stevenson²,

Kistler³

et al. 2009

Heart Rhythm

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Synergistic Action of Atrial Dilation and Sodium Channel Blockade on Conduction in Rabbit Atria

Abstract: In dilated atria, blockade of the rapid sodium channels caused a higher degree of local conduction delay and intra-atrial conduction block than in nondilated atria.

Cited by 40 publications

References 31 publications

Anti-arrhythmic Effects of I Na, I Kr, and Combined I Kr–I CaL Blockade in an Experimental Model of Acute Stretch-Related Atrial Fibrillation

Anti-arrhythmic Effects of I Na, I Kr, and Combined I Kr–I CaL Blockade in an Experimental Model of Acute Stretch-Related Atrial Fibrillation

Electropathological Substrate of Long-Standing Persistent Atrial Fibrillation in Patients With Structural Heart Disease

The role of chronic atrial stretch and atrial fibrillation on posterior left atrial wall conduction

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