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Electrophysiological Effects of Acute Atrial Stretch on Persistent Atrial Fibrillation in Patients undergoing Open Heart Surgery.
MedLine Citation:
PMID:  23128018     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: We studied the electrophysiologic effects of acute atrial dedilatation and subsequent dilatation, in patients with long-lasting persistent atrial fibrillation (AF) with structural heart disease undergoing elective cardiac surgery. METHODS: Nine patients were studied. Mean age was 71±10 years, and left ventricular ejection was 46±6%. Patients had at least moderate mitral valve regurgitation and dilated atria. After sternotomy and during extracorporal circulation, mapping was performed on the beating heart with 2 multi-electrode arrays (60 electrodes each, interelectrode distance 1.5 mm) positioned on the lateral wall of the right atrium (RA) and left atrium (LA). Atrial pressure and size were altered by modifying extracorporal circulation. Atrial fibrillation electrograms were recorded at baseline, after dedilation and after dilatation of the atria afterwards. RESULTS: At baseline median, AF cycle length (mAFCL) was 184±27ms in RA and 180±17ms in LA. After dedilatation, mAFCL shortened significantly to 168±13 in RA and to 168±20ms in LA. Dilatation lengthened mAFCL significantly in RA to 189±17ms and in LA to 185±23ms. Conduction block (CB) at baseline was 14.3±3.6% in RA and 17.3±5.5% in LA. CB decreased significantly with dedilatation to 7.4±2.9 in RA and to 7.9±6.3% in LA. CB increased significantly with dilatation afterwards to 15.0±8.3% in RA and to 18.5±16.0% in LA. CONCLUSIONS: Acute dedilatation of the atria in patients with longstanding persistent atrial fibrillation causes a decrease in mAFCL in both atria. Subsequent dilatation increased mAFCL. The amount of CB decreased with dedilatation and increased with dilatation afterwards, in both atria.
Authors:
Arif Elvan; Ahmet Adiyaman; Rypko J Beukema; Hauw T Sie; Maurits A Allessie
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-2
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-6     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 © 2012. Published by Elsevier Inc.
Affiliation:
Department of Cardiology, Isala klinieken, Zwolle, the Netherlands. Electronic address: v.r.c.derks@isala.nl.
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