Autonomic modulation impacts conduction velocity dynamics and wavefront propagation in the left atrium
Abstract Aims Atrial fibrosis and autonomic remodelling are proposed pathophysiological mechanisms in atrial fibrillation (AF). Their impact on conduction velocity (CV) dynamics and wavefront propagation was evaluated. Methods and results Local activation times (LATs), voltage, and geometry data wer...
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Veröffentlicht in: | Europace (London, England) England), 2024-08, Vol.26 (9) |
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Sprache: | eng |
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Zusammenfassung: | Abstract
Aims
Atrial fibrosis and autonomic remodelling are proposed pathophysiological mechanisms in atrial fibrillation (AF). Their impact on conduction velocity (CV) dynamics and wavefront propagation was evaluated.
Methods and results
Local activation times (LATs), voltage, and geometry data were obtained from patients undergoing ablation for persistent AF. LATs were obtained at three pacing intervals (PIs) in sinus rhythm (SR). LATs were used to determine CV dynamics and their relationship to local voltage amplitude. The impact of autonomic modulation- pharmacologically and with ganglionated plexi (GP) stimulation, on CV dynamics, wavefront propagation, and pivot points (change in wavefront propagation of ≥90°) was determined in SR. Fifty-four patients were included. Voltage impacted CV dynamics whereby at non-low voltage zones (LVZs) (≥0.5 mV) the CV restitution curves are steeper [0.03 ± 0.03 m/s ΔCV PI 600–400 ms (PI1), 0.54 ± 0.09 m/s ΔCV PI 400–250 ms (PI2)], broader at LVZ (0.2–0.49 mV) (0.17 ± 0.09 m/s ΔCV PI1, 0.25 ± 0.11 m/s ΔCV PI2), and flat at very LVZ ( |
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ISSN: | 1099-5129 1532-2092 1532-2092 |
DOI: | 10.1093/europace/euae219 |