Key result
Patients with mitral valve disease had a higher maximal degree of conduction delay at the lateral left atrium compared to patients with aortic valve disease (4.2 vs 2.3%/cm2).
Why the study?
Different arrhythmogenic substrates for AF may underlie aortic valve and mitral valve disease.
Does the type of valvular heart disease (mitral vs aortic) affect the distribution of atrial conduction disorders during sinus rhythm?
Observational (n=139)
No
Does the type of valvular heart disease (mitral vs aortic) affect the distribution of atrial conduction disorders during sinus rhythm?
Absolute Event Rate: 4.2% vs 2.3%
p-value: p=0.001
Mitral valve disease is associated with more conduction disorders at the lateral left atrium during sinus rhythm compared to aortic valve disease, and conduction disturbances at Bachmann's bundle strongly correlate with a history of atrial fibrillation.
MV disease links to greater lateral LA conduction delay than AV disease; leaves open mechanistic ties to AF and need for prospective data.
Different arrhythmogenic substrates for atrial fibrillation (AF) may underlie aortic valve (AV) and mitral valve (MV) disease. We located conduction disorders during sinus rhythm by high-resolution epicardial mapping in patients undergoing AV ( n = 85) or MV ( n = 54) surgery. Extent and distribution of conduction delay (CD) and block (CD) across the entire right and left atrial surface was determined from circa 1880 unipolar electrogram recordings per patient. CD and CB were most pronounced at the superior intercaval area (2.5% of surface, maximal degree 6.6%/cm 2 ). MV patients had a higher maximal degree of CD at the lateral left atrium than AV patients (4.2 vs 2.3%/cm 2 , p = 0.001). A history of AF was most strongly correlated to CD/CB at Bachmann’s bundle and age. Although MV patients have more conduction disorders at the lateral left atrium, disturbed conduction at Bachmann’s bundle during sinus rhythm indicates the presence of atrial remodeling which is related to AF episodes.
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Does et al. (2019) conducted an observational in Valvular heart disease (n=139). Mitral valve disease vs. Aortic valve disease was evaluated on Maximal degree of conduction delay at the lateral left atrium (%/cm2) (p=0.001). Patients with mitral valve disease had a higher maximal degree of conduction delay at the lateral left atrium compared to patients with aortic valve disease (4.2 vs 2.3%/cm2).
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