Document Detail

Relevance of Electrical Remodeling in Human Atrial Fibrillation: Results of the ASSERT Mechanisms of Atrial Fibrillation Study.
MedLine Citation:
PMID:  22670051     Owner:  NLM     Status:  Publisher    
BACKGROUND: -In animal models of atrial fibrillation (AF), changes in atrial electrophysiologic (EP) properties are associated with the development of AF. Their relevance to human AF is unclear. METHODS AND RESULTS: -The ASSERT trial enrolled 2580 patients receiving a dual-chamber pacemaker, who were over the age of 65 years and had a history of hypertension, but no history of AF. Serial non-invasive EP testing was performed over 2 years, in a sub-group of 485 patients. There were no differences in clinical characteristics between patients with and without device-detected atrial tachyarrhythmias (AT) during the first year. Patients with AT had longer paced (153 ± 29 vs. 145 ± 28 msec, p=0.046) and sensed (128 ± 46 vs. 118 ± 25 msec, p=0.0 p=0.06) p-wave durations and were more likely to have AF induced during EP testing (23.5% vs. 13.6%, p=0.03). They had similar corrected sinus node recovery times (cSNRT) at 90 beats per minute (388 ± 554 vs. 376 ± 466 msec, p=0.86), atrial effective refractory periods (AERP) at 90 beats per minute (250 ± 32 vs. 248 ± 36 msec, p=0.70) and rate-adaptive shortening of the AERP (14 ± 13 vs. 12 ± 14 msec, p=0.11). There were no significant differences in the change in electrophysiologic properties over 2 years between patients with and without AT. CONCLUSIONS: -Prolonged p-wave duration, but not differences in AERP was associated with the development of AT in pacemaker patients. Clinical Trial Registration; Identifier: NCT00256152.
Jeff S Healey; Carsten W Israel; Stuart J Connolly; Stefan H Hohnloser; Girish M Nair; Syamkumar Divakaramenon; Alessandro Capucci; Isabelle C Van Gelder; Chu-Pak Lau; Michael R Gold; Mark Carlson; Ellison Themeles; Carlos A Morillo
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-5
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 Population Health Research Institute, McMaster University, Hamilton, Canada;
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