| Effect of pulmonary vein isolation on the left-to-right atrial dominant frequency gradient in human atrial fibrillation. | |
| | |
MedLine Citation:
|
PMID: 16876735 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: We previously demonstrated the existence of a left-to-right atrial dominant frequency gradient during paroxysmal but not persistent atrial fibrillation (AF) in humans. One possible mechanism of the left-to-right dominant frequency gradient involves the role of the pulmonary veins (PVs) in AF maintenance. OBJECTIVES: The purpose of this study was to examine the effect of PV isolation on the dominant frequency gradient and outcome after PV isolation. METHODS: Patients with either paroxysmal or persistent AF were studied. Recordings were made from catheters in the coronary sinus (CS), posterior right atrium (RA), and posterior left atrium (LA) during AF before and after PV isolation. Mean left-to-right dominant frequency gradient was measured before and after segmental PV isolation. Patients were followed for AF recurrence after PV isolation. RESULTS: Twenty-seven patients with paroxysmal (n = 15) or persistent (n = 12) AF were studied. In the paroxysmal group, baseline dominant frequency was greatest in the posterior LA with a significant left-to-right atrial dominant frequency gradient (posterior LA = 6.2 +/- 0.9 Hz, CS = 5.8 +/- 0.8 Hz, posterior RA = 5.4 +/- 0.9 Hz; P <.001). After PV isolation, there was no regional difference in dominant frequency (5.9 +/- 0.7 Hz vs 5.7 +/- 0.6 Hz vs 5.7 +/- 0.7 Hz, respectively; P = NS). In the persistent AF group, there was no overall difference in dominant frequency among sites before or after PV isolation (P = NS); however, patients with long-term freedom from AF after PV isolation had a higher left-to-right dominant frequency gradient compared with patients with recurrent AF (0.4 vs 0.1 Hz; P <.05). CONCLUSION: PV isolation results in a loss in the left-to-right dominant frequency gradient in patients with paroxysmal AF. This finding supports the critical role of PVs in the maintenance of ongoing paroxysmal AF. Patients with persistent AF and a baseline left-to-right dominant frequency gradient have a better success rate with PV isolation alone compared with patients without a dominant frequency gradient. |
| | |
Authors:
|
Sorin Lazar; Sanjay Dixit; David J Callans; David Lin; Francis E Marchlinski; Edward P Gerstenfeld |
Related Documents
:
|
12086215 - High frame rate myocardial integrated backscatter. does this change our understanding o... 18638595 - Aldosterone synthase gene polymorphism as a determinant of atrial fibrillation in patie... 15020515 - Fibrosis in left atrial tissue of patients with atrial fibrillation with and without un... 18080705 - Current status of the surgical treatment of atrial fibrillation. 7094445 - The acute electrophysiological effects of intravenous metoprolol. 1734295 - A quantitative mri study of vascular dementia. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-04-22 |
Journal Detail:
|
Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 3 ISSN: 1547-5271 ISO Abbreviation: Heart Rhythm Publication Date: 2006 Aug |
Date Detail:
|
Created Date: 2006-07-31 Completed Date: 2007-01-09 Revised Date: 2009-10-27 |
Medline Journal Info:
|
Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
|
Languages: eng Pagination: 889-95 Citation Subset: IM |
Affiliation:
|
Department of Medicine, Electrophysiology Division, University of Pennsylvania Health System, Philadelphia, 19104, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Analysis of Variance Atrial Fibrillation / epidemiology, physiopathology*, surgery* Body Surface Potential Mapping Cardiac Pacing, Artificial Catheter Ablation* Confounding Factors (Epidemiology) Electrophysiologic Techniques, Cardiac Female Follow-Up Studies Heart Conduction System / physiopathology*, surgery* Humans Male Middle Aged Pulmonary Veins / surgery* Recurrence Reoperation Signal Processing, Computer-Assisted Treatment Outcome |
| Comments/Corrections | |
Comment In:
|
Heart Rhythm. 2006 Aug;3(8):896-7
[PMID:
16876736
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Lipid-lowering drug use is associated with reduced prevalence of atrial fibrillation in patients wit...
Next Document: Identifying far-field superior vena cava potentials within the right superior pulmonary vein.