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Titolo:
Role of dispersion of atrial refractoriness in the recurrence of clinical atrial fibrillation - A manifestation of atrial electrical remodelling in humans?
Autore:
Fynn, SP; Todd, DM; Hobbs, WJC; Armstrong, KL; Garratt, CJ;
Indirizzi:
Manchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, England Manchester Royal Infirm Manchester Lancs England M13 9WL , Lancs, England
Titolo Testata:
EUROPEAN HEART JOURNAL
fascicolo: 19, volume: 22, anno: 2001,
pagine: 1822 - 1834
SICI:
0195-668X(200110)22:19<1822:RODOAR>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
ELECTROPHYSIOLOGICAL CHARACTERISTICS; TACHYCARDIA; CARDIOVERSION; DOGS; VULNERABILITY; MECHANISMS; SUBSTRATE; REVERSAL; MODEL;
Keywords:
atrial electrical remodelling; atrial fibrillation; atrial fibrillation cycle length; cardioversion; dispersion of atrial refractoriness;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Garratt, CJ Manchester Heart Ctr, Oxford Rd, Manchester M13 9WL, Lancs, England Manchester Heart Ctr Oxford Rd Manchester Lancs England M13 9WL
Citazione:
S.P. Fynn et al., "Role of dispersion of atrial refractoriness in the recurrence of clinical atrial fibrillation - A manifestation of atrial electrical remodelling in humans?", EUR HEART J, 22(19), 2001, pp. 1822-1834

Abstract

Aims The mechanism of atrial fibrillation recurrence following cardioversion is unknown, although experimental studies have indicated that changes indispersion of atrial refractoriness may play a role. The aims of this study were to assess (1) if dispersion of atrial refractoriness is relevant to atrial fibrillation recurrence and (2) if dispersion of refractoriness is part of the atrial electrical remodelling process in humans. Methods and Results Thirty-seven consecutive patients underwent internal cardioversion (CV1) of persistent atrial fibrillation. Patients were monitored by daily transtelephonic recordings following discharge and if there wasspontaneous atrial fibrillation recurrence they were rapidly admitted for repeat cardioversion (CV2). We used the 5th percentile of 100 consecutive atrial fibrillation cycle lengths (AFCL(p5)) and the atrial effective refractory period (AERP) as measures of atrial refractoriness at four different atrial sites. Dispersion of AFCL(P5) at CV I was significantly higher in those who had subsequent recurrence of atrial fibrillation than in those who remained in sinus rhythm for at least 1 month after cardioversion (35 +/- 17ms vs 9 +/- 13 ms; P <0-02). Dispersion of AFCL(P5) measured at CV2 was significantly lower than that measured in the same patients at CV1 (19 +/- 8 ins vs 35 +/- 11 ms; P=0.02). i.e. dispersion of AFCL(P5) had reduced following a period of sinus rhythm. In contrast, there was no difference in dispersion of AERP between the recurrers and non-recurrers. Dispersion of AERP between CV1 and CV2 did not change following a period of sinus rhythm. Conclusion Dispersion of AFCL is relevant to atrial fibrillation recurrence and may represent a manifestation of atrial electrical remodelling in humans. Treatment directed at AFCL dispersion may be useful in the suppressionof atrial fibrillation recurrence following card ioversion. (C) 2001 The European Society of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/08/20 alle ore 00:10:15