Why the study?
The influence of acetylcholine on electrical conduction in human atria and its contribution to AF were unclear, especially combined with impaired conduction from interstitial fibrosis.
Population
Human AF computer models, isolated human atrial myocytes, and LAAs from AF patients
Comparison
Pacing with acetylcholine vs without acetylcholine
Design
Computational, experimental, and ex vivo translational study
Authors
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Supports cholinergic facilitation of reentry in fibrotic atria; leaves open whether targeting acetylcholine signaling warrants clinical study in AF.
Acetylcholine facilitates atrial fibrillation in fibrotic atria by shortening action potential duration and slowing conduction, which promotes unidirectional conduction block and reentry.
Bayer et al. (2019) studied this question.
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