Electrical remodeling of the atria associated with paroxysmal and chronic atrial flutter
Atrial electrical remodeling may be important for the initiation and perpetuation of atrial arrhythmias. Whether paroxysmal atrial flutter (AFL) and chronic AFL cause electrical remodeling of the atria has not been conclusively determined. Before radiofrequency ablation of paroxysmal AFL, 15 patient...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2000-10, Vol.102 (15), p.1807-1813 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | SPARKS, Paul B JAYAPRAKASH, Shenthar VOHRA, Jitendra K KALMAN, Jonathan M |
| description | Atrial electrical remodeling may be important for the initiation and perpetuation of atrial arrhythmias. Whether paroxysmal atrial flutter (AFL) and chronic AFL cause electrical remodeling of the atria has not been conclusively determined.
Before radiofrequency ablation of paroxysmal AFL, 15 patients in sinus rhythm were evaluated under autonomic blockade. Lateral right atrial (LRA) effective refractory periods (ERPs) at 600 and 450 ms were measured before and at 1-minute intervals for 10 minutes after spontaneous or pace termination of a 5- to 10-minute period of induced AFL. In 10 patients with chronic AFL, LRA, septal, and coronary sinus (CS) ERPs and corrected sinus node recovery times (cSNRTs) at 600 and 450 ms were measured under autonomic blockade 15 minutes, 30 minutes, and 3 weeks after termination of chronic AFL by ablation. In the paroxysmal AFL group, LRA ERPs decreased by 18% at 600 ms and 12% at 450 ms (P: |
| doi_str_mv | 10.1161/01.CIR.102.15.1807 |
| format | Article |
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Before radiofrequency ablation of paroxysmal AFL, 15 patients in sinus rhythm were evaluated under autonomic blockade. Lateral right atrial (LRA) effective refractory periods (ERPs) at 600 and 450 ms were measured before and at 1-minute intervals for 10 minutes after spontaneous or pace termination of a 5- to 10-minute period of induced AFL. In 10 patients with chronic AFL, LRA, septal, and coronary sinus (CS) ERPs and corrected sinus node recovery times (cSNRTs) at 600 and 450 ms were measured under autonomic blockade 15 minutes, 30 minutes, and 3 weeks after termination of chronic AFL by ablation. In the paroxysmal AFL group, LRA ERPs decreased by 18% at 600 ms and 12% at 450 ms (P:<0.01) after induced AFL and recovered to baseline over approximately 5 minutes. Atrial fibrillation developed during AFL in 3 patients and during ERP testing in 3 patients when refractoriness was at its nadir. In the chronic AFL group, LRA, septal, and CS ERPs at 3 weeks were significantly greater than at 15 and 30 minutes after termination of chronic AFL at both cycle lengths (P:<0.01). Three weeks after ablation, cSNRT decreased 35% at 600 ms (P:<0.05) and decreased 44% at 450 ms (P:<0. 05). Both ERPs and cSNRTs measured 15 and 30 minutes after ablation of chronic AFL were not significantly different.
Both paroxysmal AFL and chronic AFL cause reversible electrical remodeling of the atria but demonstrate different time courses of recovery.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.102.15.1807</identifier><identifier>PMID: 11023936</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Atrial Fibrillation - etiology ; Atrial Flutter - complications ; Atrial Flutter - physiopathology ; Biological and medical sciences ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Catheter Ablation ; Chronic Disease ; Electrophysiology ; Female ; Heart ; Heart Atria - physiopathology ; Humans ; Male ; Medical sciences ; Middle Aged ; Prospective Studies</subject><ispartof>Circulation (New York, N.Y.), 2000-10, Vol.102 (15), p.1807-1813</ispartof><rights>2000 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Oct 10, 2000</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-7c9e7d8ecd49bb6c8182e9916f0ce78c3d7b1800021d6370c782ad1158be0d1c3</citedby><cites>FETCH-LOGICAL-c442t-7c9e7d8ecd49bb6c8182e9916f0ce78c3d7b1800021d6370c782ad1158be0d1c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1523764$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11023936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SPARKS, Paul B</creatorcontrib><creatorcontrib>JAYAPRAKASH, Shenthar</creatorcontrib><creatorcontrib>VOHRA, Jitendra K</creatorcontrib><creatorcontrib>KALMAN, Jonathan M</creatorcontrib><title>Electrical remodeling of the atria associated with paroxysmal and chronic atrial flutter</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Atrial electrical remodeling may be important for the initiation and perpetuation of atrial arrhythmias. Whether paroxysmal atrial flutter (AFL) and chronic AFL cause electrical remodeling of the atria has not been conclusively determined.
Before radiofrequency ablation of paroxysmal AFL, 15 patients in sinus rhythm were evaluated under autonomic blockade. Lateral right atrial (LRA) effective refractory periods (ERPs) at 600 and 450 ms were measured before and at 1-minute intervals for 10 minutes after spontaneous or pace termination of a 5- to 10-minute period of induced AFL. In 10 patients with chronic AFL, LRA, septal, and coronary sinus (CS) ERPs and corrected sinus node recovery times (cSNRTs) at 600 and 450 ms were measured under autonomic blockade 15 minutes, 30 minutes, and 3 weeks after termination of chronic AFL by ablation. In the paroxysmal AFL group, LRA ERPs decreased by 18% at 600 ms and 12% at 450 ms (P:<0.01) after induced AFL and recovered to baseline over approximately 5 minutes. Atrial fibrillation developed during AFL in 3 patients and during ERP testing in 3 patients when refractoriness was at its nadir. In the chronic AFL group, LRA, septal, and CS ERPs at 3 weeks were significantly greater than at 15 and 30 minutes after termination of chronic AFL at both cycle lengths (P:<0.01). Three weeks after ablation, cSNRT decreased 35% at 600 ms (P:<0.05) and decreased 44% at 450 ms (P:<0. 05). Both ERPs and cSNRTs measured 15 and 30 minutes after ablation of chronic AFL were not significantly different.
Both paroxysmal AFL and chronic AFL cause reversible electrical remodeling of the atria but demonstrate different time courses of recovery.</description><subject>Aged</subject><subject>Atrial Fibrillation - etiology</subject><subject>Atrial Flutter - complications</subject><subject>Atrial Flutter - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Catheter Ablation</subject><subject>Chronic Disease</subject><subject>Electrophysiology</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Atria - physiopathology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE1r3DAQhkVpaDZp_0APRZSQmx2NZFnWsSz5gkAgpNCbkKVx18G2tpJNu_--WnZhIadhmOcdZh5CvgIrAWq4YVCuH19KYLwEWULD1AeyAsmropJCfyQrxpgulOD8nFyk9JbbWij5iZxDzggt6hX5dTugm2Pv7EAjjsHj0E-_aejovEFq88RSm1JwvZ3R07_9vKFbG8O_XRpzxE6euk0MU-8O8EC7YZlnjJ_JWWeHhF-O9ZL8vLt9XT8UT8_3j-sfT4WrKj4XymlUvkHnK922tWug4ag11B1zqBonvGrzZ4xx8Pl45lTDrQeQTYvMgxOX5PqwdxvDnwXTbMY-ORwGO2FYklFccKV0lcHv78C3sMQp32Y4cCW1lHuIHyAXQ0oRO7ON_WjjzgAze-mGgcnSc8sNSLOXnkPfjpuXdkR_ihwtZ-DqCNiURXfRTq5PJ05yoepK_Ac7XIm6</recordid><startdate>20001010</startdate><enddate>20001010</enddate><creator>SPARKS, Paul B</creator><creator>JAYAPRAKASH, Shenthar</creator><creator>VOHRA, Jitendra K</creator><creator>KALMAN, Jonathan M</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20001010</creationdate><title>Electrical remodeling of the atria associated with paroxysmal and chronic atrial flutter</title><author>SPARKS, Paul B ; JAYAPRAKASH, Shenthar ; VOHRA, Jitendra K ; KALMAN, Jonathan M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-7c9e7d8ecd49bb6c8182e9916f0ce78c3d7b1800021d6370c782ad1158be0d1c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - etiology</topic><topic>Atrial Flutter - complications</topic><topic>Atrial Flutter - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Catheter Ablation</topic><topic>Chronic Disease</topic><topic>Electrophysiology</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Atria - physiopathology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SPARKS, Paul B</creatorcontrib><creatorcontrib>JAYAPRAKASH, Shenthar</creatorcontrib><creatorcontrib>VOHRA, Jitendra K</creatorcontrib><creatorcontrib>KALMAN, Jonathan M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SPARKS, Paul B</au><au>JAYAPRAKASH, Shenthar</au><au>VOHRA, Jitendra K</au><au>KALMAN, Jonathan M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Electrical remodeling of the atria associated with paroxysmal and chronic atrial flutter</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2000-10-10</date><risdate>2000</risdate><volume>102</volume><issue>15</issue><spage>1807</spage><epage>1813</epage><pages>1807-1813</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Atrial electrical remodeling may be important for the initiation and perpetuation of atrial arrhythmias. Whether paroxysmal atrial flutter (AFL) and chronic AFL cause electrical remodeling of the atria has not been conclusively determined.
Before radiofrequency ablation of paroxysmal AFL, 15 patients in sinus rhythm were evaluated under autonomic blockade. Lateral right atrial (LRA) effective refractory periods (ERPs) at 600 and 450 ms were measured before and at 1-minute intervals for 10 minutes after spontaneous or pace termination of a 5- to 10-minute period of induced AFL. In 10 patients with chronic AFL, LRA, septal, and coronary sinus (CS) ERPs and corrected sinus node recovery times (cSNRTs) at 600 and 450 ms were measured under autonomic blockade 15 minutes, 30 minutes, and 3 weeks after termination of chronic AFL by ablation. In the paroxysmal AFL group, LRA ERPs decreased by 18% at 600 ms and 12% at 450 ms (P:<0.01) after induced AFL and recovered to baseline over approximately 5 minutes. Atrial fibrillation developed during AFL in 3 patients and during ERP testing in 3 patients when refractoriness was at its nadir. In the chronic AFL group, LRA, septal, and CS ERPs at 3 weeks were significantly greater than at 15 and 30 minutes after termination of chronic AFL at both cycle lengths (P:<0.01). Three weeks after ablation, cSNRT decreased 35% at 600 ms (P:<0.05) and decreased 44% at 450 ms (P:<0. 05). Both ERPs and cSNRTs measured 15 and 30 minutes after ablation of chronic AFL were not significantly different.
Both paroxysmal AFL and chronic AFL cause reversible electrical remodeling of the atria but demonstrate different time courses of recovery.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>11023936</pmid><doi>10.1161/01.CIR.102.15.1807</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Atrial Fibrillation - etiology Atrial Flutter - complications Atrial Flutter - physiopathology Biological and medical sciences Cardiac dysrhythmias Cardiology. Vascular system Catheter Ablation Chronic Disease Electrophysiology Female Heart Heart Atria - physiopathology Humans Male Medical sciences Middle Aged Prospective Studies |
| title | Electrical remodeling of the atria associated with paroxysmal and chronic atrial flutter |
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