Chronic atrial fibrillation was associated with significantly prolonged interatrial conduction and a reversed spatial distribution of atrial refractoriness compared to paroxysmal AF and controls.
Observational (n=29)
INTRODUCTION: The regional changes in atrial electrophysiologic properties related to atrial fibrillation (AF) in patients with paroxysmal AF (PAF) and chronic AF (CAF) remain unclear. The purpose of this study was to investigate the regional changes in atrial electrophysiology in patients with AF. METHODS AND RESULTS: We evaluated the atrial electrophysiology at different sites (high right atrium, low right atrium LRA, and distal coronary sinus DCS) in 11 patients with CAF, 8 patients with PAF, and 10 controls. Patients with CAF had significantly prolonged interatrial conduction and corrected sinus node recovery time, and shortened atrial effective refractory period (ERP) with loss of rate-related adaptation in the DCS, but had paradoxic prolongation of atrial ERP in the LRA, as compared with patients with PAF and the controls. As a result, the spatial distribution of atrial ERP that was observed in the controls and in patients with PAF was reversed in patients with CAF, without an increase in the dispersion of atrial refractoriness. Patients with PAF showed intermediate changes in atrial conduction times and atrial refractoriness as compared with patients with CAF and controls. CONCLUSION: There was a regional heterogeneity on the changes of atrial electrophysiology in different parts of the atrium, and the "normal" spatial distribution of atrial refractoriness was reversed in patients with CAF. The electrophysiologic changes observed in patients with PAF appear to behave as if in transition from the control state to CAF, suggesting progressive changes in atrial electrophysiologic properties.
Tse et al. (Mon,) conducted a observational in Atrial Fibrillation (n=29). Electrophysiologic evaluation vs. Controls was evaluated on Regional changes in atrial electrophysiology (interatrial conduction, corrected sinus node recovery time, atrial effective refractory period). Chronic atrial fibrillation was associated with significantly prolonged interatrial conduction and a reversed spatial distribution of atrial refractoriness compared to paroxysmal AF and controls.