Document Detail

Sinus pacemaker function after cardioversion of chronic atrial fibrillation: is sinus node remodeling related with recurrence?
MedLine Citation:
PMID:  11469431     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The objective of this study was to investigate the temporal changes in sinus node function in postcardioversion chronic atrial fibrillation (AF) patients and their possible relation with the recurrence rates of AF. METHODS AND RESULTS: In 37 chronic AF patients, internally cardioverted to sinus rhythm, corrected sinus node recovery time (CSNRT), and the pattern of corrected return cycle lengths were assessed 5 to 20 minutes and 24 hours after conversion. The last 20 consecutive patients also were evaluated after autonomic blockade. Twenty subjects with normal atrial structure and no history of AF served as the control group. Patients were followed-up for 1 month for recurrence, and the density of supraventricular ectopic beats per hour was obtained during the first 24 hours after conversion. Fifteen patients (40.5%) relapsed during follow-up. CSNRT values at 600 msec (371 +/- 182 msec) and 500 ms (445 +/- 338 msec) were significantly higher than those of control subjects (278 +/- 157 msec, P = 0.050, and 279 +/- 130 msec, P = 0.037, respectively). Significant temporal changes in CSNRT also were observed during the first 24 hours after conversion (600 msec: 308 +/- 120 msec, P = 0.034; 500 msec: 340 +/- 208 msec, P = 0.017). No significant interaction and temporal effects were observed with regard to corrected return cycle length pattern. Similar data regarding CSNRT and corrected return cycle length pattern were obtained after autonomic blockade. Patients with abnormal CSNRT after cardioversion had higher recurrence rates (50%) than those with normal function (37%; P = NS). Patients who relapsed had a higher density of supraventricular ectopic beats per hour (159 +/- 120) compared with those who did not (35 +/- 37; P = 0.001). CONCLUSION: Depressed sinus node function is observed after conversion of chronic AF. Recovery from this abnormality and its independence from autonomic function suggest that AF remodels the sinus node. Our data do not support a causative role of sinus node function in AF recurrence, but they do indicate such a role for the density of atrial ectopic beats.
E G Manios; E M Kanoupakis; H E Mavrakis; E M Kallergis; D N Dermitzaki; P E Vardas
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  12     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-25     Completed Date:  2001-12-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  800-6     Citation Subset:  IM    
Department of Cardiology, University Hospital of Heraklion, Crete, Greece.
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MeSH Terms
Atrial Fibrillation / physiopathology*,  therapy*
Autonomic Nerve Block
Chronic Disease
Electric Countershock*
Electrocardiography, Ambulatory
Heart Conduction System
Reference Values
Refractory Period, Electrophysiological
Sinoatrial Node / drug effects,  physiopathology
Time Factors
Comment In:
J Cardiovasc Electrophysiol. 2001 Jul;12(7):807-8   [PMID:  11469432 ]

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

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