Evidence for electrical remodelling of the atrial myocardium in patients with atrial fibrillation. A study using the monophasic action potential recording technique.

Hertervig, Eva; Yuan, Shiwen; Carlson, Jonas; Kongstad-Rasmussen, Ole; Olsson, Bertil

Evidence for electrical remodelling of the atrial myocardium in patients with atrial fibrillation. A study using the monophasic action potential recording technique.

Mark

Hertervig, Eva ^LU ; Yuan, Shiwen ^LU ; Carlson, Jonas ^LU

; Kongstad-Rasmussen, Ole and Olsson, Bertil ^LU (2002) In Clinical Physiology and Functional Imaging 22(1). p.8-12

Abstract: Experimental studies have shown that remodelling of the atrial myocardium is linked to the occurrence and perpetuation of atrial fibrillation (AF). Clinical evidence, however, is insufficient. We recorded monophasic action potentials (MAP) during AF from one to three sites in the right atrium in seven patients with chronic AF (CAF) and in 11 patients with paroxysmal AF (PAF). The fibrillatory (FF) interval between two consecutive upstrokes of the MAP was measured using a computer-assisted manual method. The mean, median, 15th, 10th, 5th percentile and shortest FF intervals were calculated in each patient and used as estimates of the local atrial effective refractory period (AERP) during AF. In three patients burst pacing at 400 and 500... (More); Experimental studies have shown that remodelling of the atrial myocardium is linked to the occurrence and perpetuation of atrial fibrillation (AF). Clinical evidence, however, is insufficient. We recorded monophasic action potentials (MAP) during AF from one to three sites in the right atrium in seven patients with chronic AF (CAF) and in 11 patients with paroxysmal AF (PAF). The fibrillatory (FF) interval between two consecutive upstrokes of the MAP was measured using a computer-assisted manual method. The mean, median, 15th, 10th, 5th percentile and shortest FF intervals were calculated in each patient and used as estimates of the local atrial effective refractory period (AERP) during AF. In three patients burst pacing at 400 and 500 beats min(-1) was delivered during the MAP recording. In nine patients, the AERP was also tested using the extra stimulus technique during sinus rhythm. RESULTS: Thirty-eight recordings were obtained. The shortest FF interval was significantly shorter in patients with CAF as compared with that in patients with PAF (50+/-13 vs. 72+/-31 ms, P<005). Similar differences were seen in the mean, median, 15th, 10th, and 5th percentile FF interval. The AERP during sinusrhythm was significantly longer than the estimated AERPs (P<0 05 to P<0.01) in the nine patients. There was no significant difference in FF interval before and after the burst pacing in the three patients. CONCLUSION: The AERP was significantly shortened during AF, as compared with that during sinus rhythm, and the AERP shortening was more marked in patients with CAF than in patients with PAF. These clinical findings support the connection between the electrical remodelling and the occurrence and/ or perpetuation of the AF. (Less)

Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/108110

author

Hertervig, Eva ^LU ; Yuan, Shiwen ^LU ; Carlson, Jonas ^LU

; Kongstad-Rasmussen, Ole and Olsson, Bertil ^LU

organization

Cardiology

publishing date

2002

type

Contribution to journal

publication status

published

subject

Physiology

keywords

Comparative Study, Electrocardiography, Neurologic, Refractory Period, Middle Age, Male, Human, Heart Conduction System : physiopathology, Heart : physiopathology, Electrophysiology, Female, Chronic Disease, Atrial Function, Atrial Fibrillation : physiopathology, Action Potentials

in

Clinical Physiology and Functional Imaging

volume

22

issue

1

pages

8 - 12

publisher

John Wiley & Sons Inc.

external identifiers

pmid:12003106
wos:000174885800004
scopus:0036256818

ISSN

1475-0961

DOI

10.1046/j.1475-097X.2002.00384.x

language

English

LU publication?

yes

id

9f8d5a7e-38d7-4930-bf5a-a586017a6453 (old id 108110)

alternative location

http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12003106&dopt=Abstract

date added to LUP

2016-04-01 11:35:09

date last changed

2022-01-26 07:20:38

@article{9f8d5a7e-38d7-4930-bf5a-a586017a6453,
  abstract     = {{Experimental studies have shown that remodelling of the atrial myocardium is linked to the occurrence and perpetuation of atrial fibrillation (AF). Clinical evidence, however, is insufficient. We recorded monophasic action potentials (MAP) during AF from one to three sites in the right atrium in seven patients with chronic AF (CAF) and in 11 patients with paroxysmal AF (PAF). The fibrillatory (FF) interval between two consecutive upstrokes of the MAP was measured using a computer-assisted manual method. The mean, median, 15th, 10th, 5th percentile and shortest FF intervals were calculated in each patient and used as estimates of the local atrial effective refractory period (AERP) during AF. In three patients burst pacing at 400 and 500 beats min(-1) was delivered during the MAP recording. In nine patients, the AERP was also tested using the extra stimulus technique during sinus rhythm. RESULTS: Thirty-eight recordings were obtained. The shortest FF interval was significantly shorter in patients with CAF as compared with that in patients with PAF (50+/-13 vs. 72+/-31 ms, P&lt;005). Similar differences were seen in the mean, median, 15th, 10th, and 5th percentile FF interval. The AERP during sinusrhythm was significantly longer than the estimated AERPs (P&lt;0 05 to P&lt;0.01) in the nine patients. There was no significant difference in FF interval before and after the burst pacing in the three patients. CONCLUSION: The AERP was significantly shortened during AF, as compared with that during sinus rhythm, and the AERP shortening was more marked in patients with CAF than in patients with PAF. These clinical findings support the connection between the electrical remodelling and the occurrence and/ or perpetuation of the AF.}},
  author       = {{Hertervig, Eva and Yuan, Shiwen and Carlson, Jonas and Kongstad-Rasmussen, Ole and Olsson, Bertil}},
  issn         = {{1475-0961}},
  keywords     = {{Comparative Study; Electrocardiography; Neurologic; Refractory Period; Middle Age; Male; Human; Heart Conduction System : physiopathology; Heart : physiopathology; Electrophysiology; Female; Chronic Disease; Atrial Function; Atrial Fibrillation : physiopathology; Action Potentials}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{8--12}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Clinical Physiology and Functional Imaging}},
  title        = {{Evidence for electrical remodelling of the atrial myocardium in patients with atrial fibrillation. A study using the monophasic action potential recording technique.}},
  url          = {{http://dx.doi.org/10.1046/j.1475-097X.2002.00384.x}},
  doi          = {{10.1046/j.1475-097X.2002.00384.x}},
  volume       = {{22}},
  year         = {{2002}},
}

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Evidence for electrical remodelling of the atrial myocardium in patients with atrial fibrillation. A study using the monophasic action potential recording technique.