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Inducibility of atrial fibrillation in the absence of atrial fibrillation: what does it mean to be normal?
MedLine Citation:
PMID:  21111062     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: While inducibility of atrial fibrillation (AF) is often used as an endpoint for radiofrequency ablation of AF, little is known regarding inducibility among normals. We therefore evaluated the inducibility of AF with rapid atrial pacing in patients without a clinical history of AF after catheter ablation of supraventricular tachycardia (SVT).
METHODS: We prospectively evaluated 86 patients with no history of AF who were referred for catheter ablation of SVT. After successful ablation, two different rapid atrial pacing protocols for induction of AF were tested. First, AF induction was attempted by 5-second bursts of atrial pacing from the coronary sinus ostium (CSO) at three different cycle lengths (CLs). Next, decremental pacing was performed from the CSO starting at a CL of 250 ms to the loss of 1:1 atrial capture. This protocol was repeated 3 times for each subject.
RESULTS: Three of the subjects (3.5%) enrolled had inducible AF with the first pacing protocol. However, with the second protocol, AF was inducible in 22 patients (25.6%), including sustained AF in 16 patients (18.6%). There were significant differences in the inducibility of AF between the two atrial pacing protocols. Additionally, with the second pacing protocol, patients with a loss of 1:1 atrial capture at CL <180 ms were more easily inducible for AF (21/63 vs. 1/23; P = .006).
CONCLUSION: Using a specific, decremental pacing protocol, 26% of patients without a history of AF had inducible AF. These findings suggest that significant further investigation is needed to optimize the specificity of using AF induction as an endpoint for AF ablation.
Authors:
Wen Huang; Tong Liu; Michael Shehata; Kuijun Zhang; Yan Yao; Guodong Niu; Allen Amorn; Xiushi Liu; Sumeet S Chugh; Xunzhang Wang
Publication Detail:
Type:  Journal Article     Date:  2010-11-23
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  8     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  489-92     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Clinical Electrophysiology Laboratory and Arrhythmia Center, Fu Wai Hospital and Cardiovascular Institute, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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