Document Detail

Wavelength and conduction inhomogeneity in each atrium in patients with isolated mitral valve disease and atrial fibrillation.
MedLine Citation:
PMID:  10355693     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Patients with mitral valve disease frequently have atrial fibrillation (AF), and the left atrium is presumed to be the primary atrium that develops AF. However, it is still not clear whether the electrophysiologic abnormalities responsible for AF are confined to the left atrium in this subset of patients. METHODS AND RESULTS: To examine the AF vulnerability of each atrium, we measured the wavelength and inhomogeneity of the conduction at the lateral right atrium, lateral left atrium, and Bachmann's bundle after defibrillation of AF in seven patients undergoing the maze procedure and mitral valve surgery for AF and isolated mitral valve disease, respectively (AF group). The data were compared with five coronary surgery patients in sinus rhythm (SR group). The wavelength in the AF group was significantly shorter (P < 0.05) than in the SR group not only at the lateral left atrium (225 +/- 62 vs 285 +/- 36 mm) but also at the lateral right atrium (214 +/- 54 vs 254 +/- 34 mm). The variation coefficient of the local maximum activation phase difference in the AF group (1.9 +/- 0.8 at the right atrium, 2.1 +/- 0.8 at the lateral left atrium, and 2.0 +/- 0.6 at Bachmann's bundle) was significantly greater (P < 0.05) than in the SR group at all atrial regions. CONCLUSION: AF vulnerability was not confined to the left atrium immediately after defibrillation in AF patients with isolated mitral valve disease. Electrical remodeling resulting from perpetuation of AF, pathological changes extending to the right atrium, geometric changes caused by the atrial interactions occurring across the interatrial septum, or a combination of these may explain the results.
T Nitta; H Imura; R Bessho; H Hosaka; S Yamauchi; S Tanaka
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  10     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-07-15     Completed Date:  1999-07-15     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:  521-8     Citation Subset:  IM    
Department of Cardiothoracic Surgery, Nippon Medical School, Tokyo, Japan. Nitta_Takashi/
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MeSH Terms
Atrial Fibrillation / physiopathology*,  therapy
Coronary Artery Bypass
Coronary Disease / physiopathology,  surgery
Echocardiography, Transesophageal
Electric Countershock
Electrophysiology / methods
Follow-Up Studies
Heart Atria / physiopathology*
Heart Conduction System / physiopathology*
Heart Valve Diseases / physiopathology*,  surgery,  ultrasonography
Heart Valve Prosthesis Implantation
Middle Aged
Mitral Valve*
Monitoring, Intraoperative

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

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