Document Detail


Differences in atrial fibrillation properties under vagal nerve stimulation versus atrial tachycardia remodeling.
MedLine Citation:
PMID:  19968926     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: There are many similarities between atrial effects of atrial tachycardia remodeling (ATR) and vagal nerve stimulation (VS): both promote atrial fibrillation (AF), reduce atrial effective refractory period (AERP) and AERP rate accommodation, enhance AERP heterogeneity, and increase inward-rectifier K+ current. OBJECTIVE: This study sought to compare the consequences of ATR and VS at similar levels of AERP abbreviation in dogs. METHODS: ATR dogs (n = 6) were subjected to 7-day atrial tachypacing at 400 beats/min, with radiofrequency-induced atrioventricular block and ventricular demand pacing (80 beats/min) to control ventricular response. VS was applied in 6 matched dogs with stimulation parameters selected to produce similar mean AERP values to ATR dogs. RESULTS: ATR and VS produced similarly short AERPs (79 +/- 12 and 80 +/- 12 ms, respectively), AERP rate-adaptation loss, and AERP heterogeneity increases. Although both ATR and VS increased AF duration, VS was significantly more effective in AF promotion, with mean AF duration of 992 +/- 134 seconds, versus 440 +/- 240 seconds (P <.05) under ATR. The greater AF-promoting effect of VS was associated with greater mean dominant frequency values during AF (11.7 +/- 1.8 versus 10.0 +/- 1.3 Hz ATR, P <.05). VS greatly enhanced the spatial dominant frequency variability, increasing the coefficient of variation to 15.2 +/- 1.9 Hz, versus 8.9 +/- 1.5 Hz for ATR (P <.05), primarily by increasing the per-dog maximum dominant frequency (15.4 +/- 0.6 Hz versus 12.5 +/- 0.6 for ATR, P <.01). CONCLUSION: For matched AERP values, VS promotes AF more strongly than ATR. Despite similar AERP changes, VS produces considerably greater increases in dominant frequencies, particularly maximum values, consistent with previous suggestions that inward-rectifier K+ current enhancement is particularly effective at accelerating and stabilizing spiral wave rotors that maintain AF.
Authors:
Grigorios Katsouras; Masao Sakabe; Philippe Comtois; Ange Maguy; Brett Burstein; Peter G Guerra; Mario Talajic; Stanley Nattel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-07-21
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  6     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-12-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1465-72     Citation Subset:  IM    
Affiliation:
Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
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Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
MOP 44365//Canadian Institutes of Health Research
Comments/Corrections
Comment In:
Heart Rhythm. 2009 Oct;6(10):1473-4   [PMID:  19968927 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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