Document Detail


Reduction of P-wave duration and successful pulmonary vein isolation in patients with atrial fibrillation.
MedLine Citation:
PMID:  17655679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: We hypothesize that successful pulmonary vein (PV) isolation can shorten the P-wave duration in patients with atrial fibrillation (AF). METHODS AND RESULTS: We recorded magnified surface electrocardiogram (ECG) and P-wave signal-averaged ECG using 12 electrode leads before and after 31 PV isolation procedures in 27 patients with AF. The patients were followed for 16 +/- 4 months. Repeat ablation studies documented failed PV isolation in seven patients with AF recurrences. At baseline, the maximal P-wave duration in patients without AF recurrence (161 +/- 7 msec) was slightly shorter than that in patients with AF recurrence (168 +/- 10 msec, P < 0.05). After ablation, patients without recurrence showed a significant reduction of P-wave duration from 161 +/- 7 msec to 151 +/- 8 msec (P < 0.0001). In contrast, no change of P-wave duration was noted in patients with recurrences. These findings were confirmed with signal averaged ECG of the P-waves. Three-dimensional (3-D) computer simulation using an atrial cell model showed that elimination of the muscle sleeves inside the PV resulted in a shortening of the P-wave duration and change of the terminal portion of the P-wave morphology. CONCLUSIONS: A significant shortening of P-wave duration by P-wave signal-averaged ECG can be used as an indicator for successful PV isolation. These findings suggest that activation of the PV muscle sleeves may be an important component of the terminal portion of the P-wave on surface ECG.
Authors:
Masahiro Ogawa; Koichiro Kumagai; Marta Vakulenko; Tomoo Yasuda; Carin Siegerman; Alan Garfinkel; Peng-Sheng Chen; Keijiro Saku
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2007-07-27
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  18     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-04     Completed Date:  2007-09-24     Revised Date:  2008-04-23    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  931-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan. ogawamas@kc4.so-net.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / diagnosis,  physiopathology*,  surgery*
Catheter Ablation / methods
Computer Simulation
Electrocardiography / methods*
Female
Heart Conduction System / physiopathology*,  surgery*
Humans
Male
Middle Aged
Models, Cardiovascular*
Pulmonary Veins / physiopathology,  surgery*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P01 HL78931/HL/NHLBI NIH HHS; R01 HL78932/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2007 Sep;18(9):939-41   [PMID:  17666054 ]

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


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