Document Detail

Reverse electrical remodeling of the ventricles following successful restoration of sinus rhythm in patients with persistent atrial fibrillation.
MedLine Citation:
PMID:  20487353     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Atrial fibrillation (AF) has been shown to be associated with reduced survival and increased ventricular arrhythmogenesis. The purpose of this study was to assess the effects of AF with adequate rate control on the electrophysiologic properties of the ventricles. We hypothesized that AF results in increased ventricular arrhythmogenic risk and that reverse remodeling occurs post-successful cardioversion.
METHODS: In nine patients with persistent AF, we recorded 12-lead electrocardiograms (ECGs) and 1-hour high-resolution Holter ECGs (H12+, Mortara Instrument, Inc. Milwaukee, WI, USA; recorders [1000 sps] immediately following cardioversion (Day 1) and after 30 days of maintaining sinus rhythm (Day 30). We measured QTc, QT dispersion, and calculated estimates of mean ventricular action potential duration (RT), diastolic interval (DI), T-wave width (TW), T-wave peak-to-end, and their respective scatter on Day 1 and Day 30. Maintenance of normal sinus rhythm was confirmed with a weekly trans-telephonic ECG transmission.
RESULTS: The average QTc interval decreased from 449 ± 28 ms on Day 1 to 422 ± 36 ms on Day 30 (P = 0.04). There was no significant difference in the average QT dispersion. A significant decrease was also noted in DI and TW scatter at Day 30 when compared with Day 1 (P = 0.03 and 0.04, respectively). A decrease in RT scatter was also noted albeit not statistically significant (P = 0.07).
CONCLUSION: Our results suggest a greater propensity to ventricular arrhythmogenesis in the immediate period following restoration of sinus rhythm and reverse electrical remodeling of the ventricles during the first month after successful maintenance of sinus rhythm. (PACE 2010; 33:1198-1202).
Nazem W Akoum; Stephen L Wasmund; Robert L Lux; Mohamed H Hamdan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1198-202     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Division of Cardiology, University of Utah and Nora Eccles Harrison Cardiovascular Research and Training Institute, Salt Lake City, UT 84132, USA.
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MeSH Terms
Arrhythmias, Cardiac / physiopathology*
Atrial Fibrillation / physiopathology*
Electric Countershock*
Heart Ventricles / physiopathology
Middle Aged
Treatment Outcome
Grant Support

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