Programmed atrial stimulation induced sustained atrial fibrillation or flutter in 82.2% of patients with paroxysmal atrial fibrillation compared to 19.6% of controls (P<0.001).
Case-Control (n=91)
Does programmed atrial stimulation reveal differences in atrial vulnerability and electrophysiology between patients with and without paroxysmal atrial fibrillation?
Patients with paroxysmal atrial fibrillation demonstrate significantly higher atrial vulnerability to induced arrhythmias and longer intraatrial conduction times compared to controls.
Absolute Event Rate: 82.2% vs 19.6%
p-value: p=<0.001
For elucidation of atrial electrophysiology and vulnerability an electrophysiological study was performed in 45 patients with documented paroxysmal atrial fibrillation and a control group (n = 46). Atrial vulnerability was assessed by programmed atrial stimulation with up to two extrastimuli during sinus rhythm and paced cycle lengths of 600 msec, 430 msec and 330 msec. Sustained atrial fibrillation or flutter was induced in 37/45 patients with paroxysmal atrial fibrillation in contrast to 9/46 patients in the control group (P less than 0.001). Left atrial diameter (M-mode echocardiogram), P wave duration, sinus cycle length, sinus node recovery time, and the effective refractory period of the right atrium were not significantly different between the two study groups. Intraatrial conduction time from the high right atrium (HRA) to the basal right atrium (A) and the functional refractory period of the right atrium were significantly longer in patients with paroxysmal atrial fibrillation.
Kühlkamp et al. (Wed,) conducted a case-control in Paroxysmal atrial fibrillation (n=91). Paroxysmal atrial fibrillation vs. Control group was evaluated on Induction of sustained atrial fibrillation or flutter (p=<0.001). Programmed atrial stimulation induced sustained atrial fibrillation or flutter in 82.2% of patients with paroxysmal atrial fibrillation compared to 19.6% of controls (P<0.001).