Wavelength and Conduction Inhomogeneity in Each Atrium in Patients with Isolated Mitral Valve Disease and Atrial Fibrillation

Abstract

AF vulnerability was not confined to the left atrium immediately after defibrillation in AF patients with isolated mitral valve disease. Electrical remodeling resulting from perpetuation of AF, pathological changes extending to the right atrium, geometric changes caused by the atrial interactions occurring across the interatrial septum, or a combination of these may explain the results.

Monitoring the Progression of the Atrial Electrical Remodeling in Patients With Paroxysmal Atrial Fibrillation. Analysis of the f-f Interval During Ambulatory ECG Monitoring.

“…Several investigators have documented that the AERP was relatively short immediately after the version of persistent AF, and this short AERP was progressively prolonged during a few days after the version. [10][11][12][13][14][15][16][17] These clinical findings matched the findings in experimental studies. On the other hand, although electrical remodeling is considered to contribute to an increase in PAF duration in clinical PAF patients, it has not been documented in clinical cases because it is practically difficult to non-invasively monitor the long-term atrial electrophysiologic properties.…”

Atrial myocardial pathoelectrophysiology in adults with a secundum atrial septal defect is unaffected by closure of the defect. A study using high resolution signal-averaged orthogonal P-wave technique

“…Several reports, in different cardiac conditions, have shown that the risk of AF is associated with the prolongation of the P-wave, being a marker of altered atrial conduction [9][10][11][12].…”

Altered Patterns of Gene Expression in Response to Chronic Atrial Fibrillation

“…[1][2][3][4][5] In addition, preexisting alterations can provide a morphologic substrate which increases the likelihood of AF occurring in response to triggering. [6][7][8] At the molecular level, several AF-related alterations of the atrial tissue are known to be associated with activation of different signal transduction systems. [9][10][11] Signal transduction systems provide a dynamic interaction between extracellular cues and intracellular events and, thereby, these molecular pathways are involved in the regulation of gene expression, cell proliferation, hypertrophy, differentiation, migration, and cell death.…”