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The Biatrial Substrate Properties in Different Types of Paroxysmal Atrial Fibrillation.
MedLine Citation:
PMID:  21315847     Owner:  NLM     Status:  Publisher    
BACKGROUND: The biatrial substrate properties in patients with paroxysmal atrial fibrillation (AF) originating from the pulmonary veins (PVs) and superior vena cava (SVC) are not available. OBJECTIVE: The purpose of this study is to characterize the differences of biatrial substrate properties in patients with different types of AF. METHODS: 36 patients with paroxysmal AF originating from the PV (PV-AF) and 9 patients with paroxysmal AF initiating from the SVC (SVC-AF) were included. Regional electrogram voltage, conduction velocity (CV), and spectral analysis to identify the AF nest were performed to characterize the biatrial, PVs, and SVC substrate. RESULTS: In the LA body, the bipolar voltage, total activation time, CV, and dominant frequency (DF) were similar between the PV-AF and SVC-AF. However, in the PV regions, the electrogram voltage, CV, and DF were decreased in the PV-AF. The proportions of AF nest in the LA body (72.2% vs. 22.2%, p=0.008) and PV regions (100% vs. 22.2%, p<0.001) were higher in PV-AF compared to SVC-AF, respectively. On the other hand, lower bipolar voltage, longer total activation time, and slower CV of RA body were recognized in the SVC-AF as compared to the PV-AF. In the SVC, lower bipolar voltage, slower CV, higher DF, and higher proportions of AF nest in SVC (16.7% vs. 66.7%, p=0.002) were identified in SVC-AF. CONCLUSION: These most remodeled substrates in different types of paroxysmal AF indicated the importance of the atrial substrate in the vicinity of the arrhythmogenic thoracic veins.
Shih-Yu Huang; Yenn-Jiang Lin; Hsuan-Ming Tsao; Shih-Lin Chang; Li-Wei Lo; Hu-Feng Hu; Kazuyoshi Suenari; Yung-Kuo Lin; Jen-Hung Huang; I-Chung Chen; Wen-Chin Ko; Eng-Thiam Ong; Shih-Ann Chen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-9
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Cardiology, Cathay General Hospital, Taipei, Taiwan.
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