Frequency mapping of the pulmonary veins in paroxysmal versus permanent atrial fibrillation.
INTRODUCTION: The pulmonary veins (PVs) are a dominant source of triggers initiating atrial fibrillation (AF). While recent evidence implicates these structures in the maintenance of paroxysmal AF, their role in permanent AF is not known. The current study aims to compare the contribution of PV acti...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 17; no. 9; pp. 965 - 973 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2006
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106169207&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106169207 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Sep2006 vid: 17 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106169207 2009308333 10.1111/j.1540-8167.2006.00546.x NLM16948740 106169207 ppf: 965 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Frequency mapping of the pulmonary veins in paroxysmal versus permanent atrial fibrillation. aug: au: Sanders P Nalliah CJ Dubois R Takahashi Y Hocini M Rotter M Rostock T Sacher F Hsu L Jonsson A O'Neill MD Jais P Haissaguerre M affil: Department of Cardiology, Cardiovascular Research Centre, Level 5, McEwin Building, Royal Adelaide Hospital, Adelaide, SA 5005, Australia. prash.sanders@adelaide.edu.au. sug: subj: Atrial Fibrillation Etiology Atrial Fibrillation Physiopathology Catheter Ablation Pulmonary Veins Abnormalities Female Funding Source Male Middle Age Spectral Analysis Human Middle Aged: 45-64 years Female Male ab: INTRODUCTION: The pulmonary veins (PVs) are a dominant source of triggers initiating atrial fibrillation (AF). While recent evidence implicates these structures in the maintenance of paroxysmal AF, their role in permanent AF is not known. The current study aims to compare the contribution of PV activity to the maintenance of paroxysmal and permanent AF. METHODS AND RESULTS: Thirty-four patients with paroxysmal AF (n = 20) or permanent AF (n = 14) undergoing ablation were studied. Prior to ablation, 32 seconds of electrograms were acquired from each PV and the coronary sinus (CS). The frequency of activity of each PV and CS was defined as the highest amplitude frequency on spectral analysis. The effects of ablation on the AF cycle length (AFCL) and frequency and on AF termination were determined. Significant differences were observed between paroxysmal and permanent AF. Paroxysmal AF demonstrates higher frequency PV activity (11.0 +/- 3.1 vs 8.8 +/- 3.0 Hz; P = 0.0003) but lower CS frequency (5.8 +/- 1.2 vs 6.9 +/- 1.4 Hz; P = 0.01) and longer AFCL (182 +/- 17 vs 158 +/- 21 msec; P = 0.002), resulting in greater PV to atrial frequency gradient (7.2 +/- 2.2 vs 4.2 +/- 2.9 Hz; P = 0.006). PV isolation in paroxysmal AF resulted in a greater decrease in atrial frequency (1.0 +/- 0.7 vs -0.05 +/- 0.4 Hz; P < 0.0001), greater prolongation of the AFCL (49 +/- 35 vs 5 +/- 6 msec; P < 0.0001), and more frequent AF termination (11/20 vs 0/14; P = 0.0007) compared to permanent AF. CONCLUSION: Paroxysmal AF is associated with higher frequency PV activity and lesser CS frequency compared to permanent AF. Isolation of the PVs had a greater impact on the fibrillatory process in paroxysmal AF compared to permanent AF, suggesting that while the PVs have a role in maintaining paroxysmal AF, these structures independently contribute less to the maintenance of permanent AF. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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