| Effect of electrical and structural remodeling on spatiotemporal organization in acute and persistent atrial fibrillation. | |
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MedLine Citation:
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PMID: 12435191 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Atrial fibrillation (AF) may originate from discrete sites of periodic activity. We studied the effect of structural and electrical remodeling on spatiotemporal organization in acute and persistent AF. METHODS AND RESULTS: Atrial effective refractory periods (AERPs) were recorded from five different sites at baseline and after pacing in acute AF (n = 8 dogs) and persistent AF (n = 8). Four persistent AF dogs subsequently were cardioverted to sinus rhythm to allow AERP recovery. Periodicity was quantified by calculating power spectra on left atrial electrograms obtained from a 64-electrode basket catheter. Left atrial size was measured by intracardiac echocardiography and structural changes were assessed by electron microscopy. Mean AERPs decreased after pacing in acute (128 +/- 16 msec to 108 +/- 29 msec, P < 0.001) and persistent AF (135 +/- 16 msec to 104 +/- 24 msec, P < 0.0001). AERP recovery was established after 7 days of sinus rhythm. Structural changes were mild in acute AF, severe in persistent AF, and remained severe after AERP recovery. A single dominant frequency was identified in 94% of acute AF bipoles, 57% in persistent AF, and 76% after AERP recovery. Average correlation coefficient was 0.82 among acute AF bipoles, 0.63 in persistent AF, and 0.73 after AERP recovery. CONCLUSION: Transition from acute to persistent AF is associated with loss of spatiotemporal organization. A single dominant frequency recruits the majority of the left atrium in acute AF. Persistent AF, however, is associated with structural remodeling and dominant frequency dispersion. Recovery of refractoriness only partially restores spatiotemporal organization, indicating a major role for structural remodeling in the maintenance of persistent AF. |
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Authors:
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Joseph G Akar; Thomas H Everett; Lai-Chow Kok; J Randall Moorman; David E Haines |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 13 ISSN: 1045-3873 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-11-18 Completed Date: 2003-03-12 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1027-34 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Animals Atrial Fibrillation / physiopathology* Atrial Function / physiology* Disease Models, Animal Dogs Electrocardiography Electrophysiologic Techniques, Cardiac Entropy Female Follow-Up Studies Heart Atria / physiopathology Models, Cardiovascular Recovery of Function / physiology Refractory Period, Electrophysiological / physiology Severity of Illness Index Statistics as Topic Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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HL07355/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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