Document Detail


Left atrial pressure and dominant frequency of atrial fibrillation in humans.
MedLine Citation:
PMID:  21034858     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial stretch is thought to play a role in the development of atrial fibrillation (AF). However, the precise mechanism by which stretch contributes to AF maintenance in humans is unknown.
OBJECTIVE: The purpose of this study was to determine the impact of left atrial (LA) pressure on AF frequency in patients undergoing catheter ablation of AF.
METHODS: The subjects of this study were 58 consecutive patients with persistent AF (n = 40) or paroxysmal AF (n = 18) undergoing LA ablation. LA pressure was measured before ablation. Both atria and the coronary sinus were mapped, and regional dominant frequency (DF) was determined.
RESULTS: Mean LA pressure in the persistent AF group was significantly higher than in the paroxysmal AF group (18 ± 5 vs 10 ± 4 mmHg, P <.0001). Mean DF in the persistent AF group was also higher than in the paroxysmal AF group (6.36 ± 0.51 Hz and 5.83 ± 0.54 Hz, P = .0006). In patients with persistent AF, there was a significant correlation between LA pressure and DF at the LA appendage (r = 0.55, P = .0002). DF(max) was found at the LA appendage region in 24 (60%) of the 40 patients with persistent AF (P = .0006). In multivariate analysis, LA pressure was the only independent predictor of DF(max) in the LA appendage (P = .04, odds ratio 1.41, 95% confidence interval 1.02-1.94).
CONCLUSION: Higher LA pressure in patients with persistent AF implies that these patients are more vulnerable to stretch-related remodeling than are patients with paroxysmal AF. The DF of AF was directly related to LA pressure in patients with persistent AF. This finding suggests that atrial stretch may contribute to the maintenance of AF in humans by stabilizing high-frequency sources.
Authors:
Kentaro Yoshida; Magnus Ulfarsson; Hakan Oral; Thomas Crawford; Eric Good; Krit Jongnarangsin; Frank Bogun; Frank Pelosi; Jose Jalife; Fred Morady; Aman Chugh
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-26
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 Feb 
Date Detail:
Created Date:  2011-01-31     Completed Date:  2011-06-16     Revised Date:  2012-02-02    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Atrial Appendage / physiology
Atrial Fibrillation / diagnosis,  surgery*
Atrial Function, Left / physiology*
Chi-Square Distribution
Cohort Studies
Echocardiography / methods
Electrocardiography / methods
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pressure*
Risk Assessment
Severity of Illness Index
Tachycardia, Paroxysmal / diagnosis*,  therapy
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P01 HL039707-20/HL/NHLBI NIH HHS

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


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