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Noninvasive evidence of shortened atrial refractoriness during sinus rhythm in patients with paroxysmal atrial fibrillation.

Holmqvist, Fredrik LU ; Carlson, Jonas LU ; Waktare, Johan E P and Platonov, Pyotr LU (2009) In PACE 32(3). p.302-307
Abstract
BACKGROUND: Shortening of the atrial refractory period is the key feature of atrial electrical remodeling during atrial fibrillation (AF). During sinus rhythm (SR), assessment of the atrial refractoriness is hampered by the fact that the atrial repolarization wave (Ta wave) is largely obscured by the following QRST complex. The purpose of this study was to study the Ta wave in subjects with paroxysmal AF during SR with third-degree atrioventricular (AV) block, and in matched controls. METHODS: Fifteen patients (mean age 70 +/- 10 years, five males) with paroxysmal AF undergoing AV-nodal ablation were studied. Fifteen age- and gender-matched subjects (mean age 71 +/- 9 years, five males) with third-degree AV block, without a history of... (More)
BACKGROUND: Shortening of the atrial refractory period is the key feature of atrial electrical remodeling during atrial fibrillation (AF). During sinus rhythm (SR), assessment of the atrial refractoriness is hampered by the fact that the atrial repolarization wave (Ta wave) is largely obscured by the following QRST complex. The purpose of this study was to study the Ta wave in subjects with paroxysmal AF during SR with third-degree atrioventricular (AV) block, and in matched controls. METHODS: Fifteen patients (mean age 70 +/- 10 years, five males) with paroxysmal AF undergoing AV-nodal ablation were studied. Fifteen age- and gender-matched subjects (mean age 71 +/- 9 years, five males) with third-degree AV block, without a history of heart disease, were used as controls. Standard 12-lead electrocardiograms (ECGs) were recorded and transformed to orthogonal leads and studied using P-wave signal averaging technique. RESULTS: The P to Ta interval was shorter (408 +/- 47 ms vs 451 +/- 53 ms, P = 0.017) and in Lead Y the Ta peak location was earlier (156 +/- 31 ms vs 187 +/- 34 ms, P = 0.002) in subjects with paroxysmal AF than in the controls. The P-wave duration (126 +/- 15 ms vs 129 +/- 17 ms, P = 0.59) and morphology was similar in AF patients and controls. CONCLUSIONS: In this study, the ECG signs of shorter atrial refractoriness associated with a history of AF are visualized for the first time during SR. The finding of the earlier location of the PTa peak in AF subjects implies that a possible indicator of increased arrhythmia susceptibility may be visible already in the unprocessed ECG. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PACE
volume
32
issue
3
pages
302 - 307
publisher
Wiley-Blackwell
external identifiers
  • WOS:000263758700005
  • PMID:19272058
  • Scopus:61449202995
ISSN
1540-8159
DOI
10.1111/j.1540-8159.2008.02236.x
language
English
LU publication?
yes
id
bcc2e09e-99ab-462a-aa41-fd06a40166db (old id 1367937)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19272058?dopt=Abstract
date added to LUP
2009-04-08 10:57:12
date last changed
2016-11-01 09:59:22
@misc{bcc2e09e-99ab-462a-aa41-fd06a40166db,
  abstract     = {BACKGROUND: Shortening of the atrial refractory period is the key feature of atrial electrical remodeling during atrial fibrillation (AF). During sinus rhythm (SR), assessment of the atrial refractoriness is hampered by the fact that the atrial repolarization wave (Ta wave) is largely obscured by the following QRST complex. The purpose of this study was to study the Ta wave in subjects with paroxysmal AF during SR with third-degree atrioventricular (AV) block, and in matched controls. METHODS: Fifteen patients (mean age 70 +/- 10 years, five males) with paroxysmal AF undergoing AV-nodal ablation were studied. Fifteen age- and gender-matched subjects (mean age 71 +/- 9 years, five males) with third-degree AV block, without a history of heart disease, were used as controls. Standard 12-lead electrocardiograms (ECGs) were recorded and transformed to orthogonal leads and studied using P-wave signal averaging technique. RESULTS: The P to Ta interval was shorter (408 +/- 47 ms vs 451 +/- 53 ms, P = 0.017) and in Lead Y the Ta peak location was earlier (156 +/- 31 ms vs 187 +/- 34 ms, P = 0.002) in subjects with paroxysmal AF than in the controls. The P-wave duration (126 +/- 15 ms vs 129 +/- 17 ms, P = 0.59) and morphology was similar in AF patients and controls. CONCLUSIONS: In this study, the ECG signs of shorter atrial refractoriness associated with a history of AF are visualized for the first time during SR. The finding of the earlier location of the PTa peak in AF subjects implies that a possible indicator of increased arrhythmia susceptibility may be visible already in the unprocessed ECG.},
  author       = {Holmqvist, Fredrik and Carlson, Jonas and Waktare, Johan E P and Platonov, Pyotr},
  issn         = {1540-8159},
  language     = {eng},
  number       = {3},
  pages        = {302--307},
  publisher    = {ARRAY(0xc620710)},
  series       = {PACE},
  title        = {Noninvasive evidence of shortened atrial refractoriness during sinus rhythm in patients with paroxysmal atrial fibrillation.},
  url          = {http://dx.doi.org/10.1111/j.1540-8159.2008.02236.x},
  volume       = {32},
  year         = {2009},
}