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The Role of Impaired Interatrial Conduction in Paroxysmal Atrial Fibrillation

Platonov, Pyotr LU (2001)
Abstract (Swedish)
Popular Abstract in Swedish

Projektet har for avsikt att vardera den elektriska overledningen mellan hjartats formak och hur forsamring av denna overledning bidrar till uppkomsten av attackvis pakommande formaks- flimmer. Studierna har anvant sig av ekg- registreringar fran kroppsytan, registreringar fran hjartats insida, anatomiska dissektionsstudier och djurexperiment.



Slutsatser



1. Ofiltrerat medelvardesbildat hogupplosnings- ekg avslojade specifika forandringar hos patienter med attackvis pakommande formaksflimmer utan underliggande hjartsjukdom. Forand-ringarna var forenliga med en hamning i impulsoverledningen mellan nedre/bakre delarna av formaken. Tolkningen av dessa fynd fick... (More)
Popular Abstract in Swedish

Projektet har for avsikt att vardera den elektriska overledningen mellan hjartats formak och hur forsamring av denna overledning bidrar till uppkomsten av attackvis pakommande formaks- flimmer. Studierna har anvant sig av ekg- registreringar fran kroppsytan, registreringar fran hjartats insida, anatomiska dissektionsstudier och djurexperiment.



Slutsatser



1. Ofiltrerat medelvardesbildat hogupplosnings- ekg avslojade specifika forandringar hos patienter med attackvis pakommande formaksflimmer utan underliggande hjartsjukdom. Forand-ringarna var forenliga med en hamning i impulsoverledningen mellan nedre/bakre delarna av formaken. Tolkningen av dessa fynd fick experimentellt stod i en studie dar mot-svarande for-andring kunde noteras i ekg-registreringar fran grisar nar impulsledning i detta omrade skadats.



2. Registreringarna fran hjartats insida talar ocksa for att den primara elektriska overlednings- defekten ligger inom ett omrade som omfattar nedre/ bakre delen av formaksskiljevaggen och den del av stora hjartvenen som ligger inom detta omrade. Fynden talar vidare for att upp-splittring av den elektriska signalen inom detta omrade kan leda till en formaksflimmer-attack.



3. Vid den patologisk-anatomiska undersokningen fann vi en stor variabilitet i muskelforbindel- serna mellan de bagge formaken. Vi kunde emellertid inte notera nagon saker relation mellan denna variabilitet och tidigare forekomst av formaksflimmer. (Less)
Abstract
The aim of this thesis was to evaluate the role of interatrial conduction defects in the genesis of lone paroxysmal atrial fibrillation (AF) using combined approach of non-invasive signal-averaged P-wave ECG, invasive electrophysiological (EP) studies, anatomical studies and animal experiments.



Non-filtered signal-averaged P-wave ECG revealed irregularities in orthogonal P-wave morphology and the presence of double-peaked configurations of P-wave spatial magnitude in patients with lone paroxysmal AF compared with healthy individuals (I), suggesting the presence of interatrial conduction delays localised in the posterior-inferior interatrial route. The interpretation of human P-wave ECG was supported by the experimental... (More)
The aim of this thesis was to evaluate the role of interatrial conduction defects in the genesis of lone paroxysmal atrial fibrillation (AF) using combined approach of non-invasive signal-averaged P-wave ECG, invasive electrophysiological (EP) studies, anatomical studies and animal experiments.



Non-filtered signal-averaged P-wave ECG revealed irregularities in orthogonal P-wave morphology and the presence of double-peaked configurations of P-wave spatial magnitude in patients with lone paroxysmal AF compared with healthy individuals (I), suggesting the presence of interatrial conduction delays localised in the posterior-inferior interatrial route. The interpretation of human P-wave ECG was supported by the experimental study (V), in which similar configurations of P-wave spatial magnitudes were reproduced by the interruption of conduction over the posterior interatrial route in pigs. In a series of endocardial EP studies (II), predominant conduction disturbances within the right atrium causing localised inferior-posterior interatrial conduction delays were found in a group of patients with lone paroxysmal AF during sinus rhythm and atrial stimulation. In AF patients, induction of the arrhythmia paroxysms was associated with conduction disturbances in the posterior septal region (III), suggesting that the initial re-entry occurs there. In the pathology study (IV), we showed that in addition to the anteriorly located Bachmann's bundle, numbers of muscle bundles connect the right and the left atria across the posterior interatrial groove. These posterior interatrial routes are non-uniform structures subjected to substantial variability, which may be an anatomical prerequisite for interatrial conduction defects and explain why some patients are more prone to developing interatrial conduction blocks and atrial fibrillation than others. (Less)
Please use this url to cite or link to this publication:
author
opponent
  • Professor de Luna, Bayes, Cardiology Department, Hospital Santa Creu i Sant Pau, St. Antoni M. Claret 167, 08025 Barcelona, Spain
organization
publishing date
type
Thesis
publication status
published
subject
keywords
electrophysiology, Cardiovascular system, anatomy, interatrial conduction, lone atrial fibrillation, Kardiovaskulära systemet
pages
59 pages
publisher
Lund University
defense location
Segerfalkssalen, Wallenberg Neurocentrum, Solvegatan 17
defense date
2001-10-15 13:00
ISBN
5-94601-002-6
language
English
LU publication?
yes
id
331e22e4-8b71-4971-a096-db726fcf9f03 (old id 41842)
date added to LUP
2007-08-01 16:05:24
date last changed
2016-09-19 08:45:07
@phdthesis{331e22e4-8b71-4971-a096-db726fcf9f03,
  abstract     = {The aim of this thesis was to evaluate the role of interatrial conduction defects in the genesis of lone paroxysmal atrial fibrillation (AF) using combined approach of non-invasive signal-averaged P-wave ECG, invasive electrophysiological (EP) studies, anatomical studies and animal experiments.<br/><br>
<br/><br>
Non-filtered signal-averaged P-wave ECG revealed irregularities in orthogonal P-wave morphology and the presence of double-peaked configurations of P-wave spatial magnitude in patients with lone paroxysmal AF compared with healthy individuals (I), suggesting the presence of interatrial conduction delays localised in the posterior-inferior interatrial route. The interpretation of human P-wave ECG was supported by the experimental study (V), in which similar configurations of P-wave spatial magnitudes were reproduced by the interruption of conduction over the posterior interatrial route in pigs. In a series of endocardial EP studies (II), predominant conduction disturbances within the right atrium causing localised inferior-posterior interatrial conduction delays were found in a group of patients with lone paroxysmal AF during sinus rhythm and atrial stimulation. In AF patients, induction of the arrhythmia paroxysms was associated with conduction disturbances in the posterior septal region (III), suggesting that the initial re-entry occurs there. In the pathology study (IV), we showed that in addition to the anteriorly located Bachmann's bundle, numbers of muscle bundles connect the right and the left atria across the posterior interatrial groove. These posterior interatrial routes are non-uniform structures subjected to substantial variability, which may be an anatomical prerequisite for interatrial conduction defects and explain why some patients are more prone to developing interatrial conduction blocks and atrial fibrillation than others.},
  author       = {Platonov, Pyotr},
  isbn         = {5-94601-002-6},
  keyword      = {electrophysiology,Cardiovascular system,anatomy,interatrial conduction,lone atrial fibrillation,Kardiovaskulära systemet},
  language     = {eng},
  pages        = {59},
  publisher    = {Lund University},
  school       = {Lund University},
  title        = {The Role of Impaired Interatrial Conduction in Paroxysmal Atrial Fibrillation},
  year         = {2001},
}