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Atrial Vulnerability (atrial + vulnerability)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Sinoatrial Remodeling Caused by Persistent Atrial Fibrillation: What is the Relationship Between Postcardioversion Sinus Node Dysfunction and Increased Atrial Vulnerability?

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 7 2001
ARIF ELVAN M.D.
[source]

Electrophysiological Characteristics and Catheter Ablation in Patients with Paroxysmal Supraventricular Tachycardia and Paroxysmal Atrial Fibrillation

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 4 2008
SHIH-LIN CHANG M.D.
Introduction: Paroxysmal supraventricular tachycardia (PSVT) is often associated with paroxysmal atrial fibrillation (AF). However, the relationship between PSVT and AF is still unclear. The aim of this study was to investigate the clinical and electrophysiological characteristics in patients with PSVT and AF, and to demonstrate the origin of the AF before the radiofrequency (RF) ablation of AF. Methods and Results: Four hundred and two consecutive patients with paroxysmal AF (338 had a pure PV foci and 64 had a non-PV foci) that underwent RF ablation were included. Twenty-one patients (10 females; mean age 47 ± 18 years) with both PSVT and AF were divided into two groups. Group 1 consisted of 14 patients with inducible atrioventricular nodal reentrant tachycardia (AVNRT) and AF. Group 2 consisted of seven patients with Wolff-Parkinson-White (WPW) syndrome and AF. Patients with non-PV foci of AF had a higher incidence of AVNRT than those with PV foci (11% vs. 2%, P = 0.003). Patients with AF and atypical AVNRT had a higher incidence of AF ectopy from the superior vena cava (SVC) than those with AF and typical AVNRT (86% vs. 14%, P = 0.03). Group 1 patients had smaller left atrial (LA) diameter (36 ± 3 vs. 41 ± 3 mm, P = 0.004) and higher incidence of an SVC origin of AF (50% vs. 0%, P = 0.047) than did those in Group 2. Conclusion: The SVC AF has a close relationship with AVNRT. The effect of atrial vulnerability and remodeling may differ between AVNRT and WPW syndrome. [source]

Clinical Significance of the Atrial Fibrillation Threshold in Patients with Paroxysmal Atrial Fibrillation

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2001
KEIJI INOUE
INOUE, K., et al.: Clinical Significance of the Atrial Fibrillation Threshold in Patients with Paroxysmal Atrial Fibrillation. AF threshold and the other electrophysiological parameters were measured to quantify atrial vulnerability in patients with paroxysmal atrial fibrillation (PAF, n = 47), and those without AF (non-PAF, n = 25). Stimulations were delivered at the right atrial appendage with a basic cycle length of 500 ms. The PAF group had a significantly larger percentage of maximum atrial fragmentation (%MAF, non-PAF: mean ± SD = 149 ± 19%, PAF: 166 ± 26%, P = 0.009), fragmented atrial activity zone (FAZ, non-PAF: median 0 ms, interquartile range 0,20 ms, PAF: 20 ms, 10,40 ms, P = 0.008). Atrial fibrillation threshold (AF threshold, non-PAF: median 11 mA, interquartile range 6,21 mA, PAF: 5 mA, 3,6 mA, P < 0.001) was smaller in the PAF group than in the non-PAF group. Sensitivity, specificity, and positive predictive value of electrophysiological parameters were as follows, respectively: %MAF (cut off at 150%, 78%, 52%, 76%), FAZ (cut off at 20 ms, 47%, 84%, 85%), AF threshold (cut off at 10 mA, 94%, 60%, 81%). There were no statistically significant differences between the non-PAF and PAF groups in the other parameters (effective refractory period, interatrial conduction time, maximum conduction delay, conduction delay zone, repetitive atrial firing zone, wavelength index), that were not specific for PAF. In conclusion, the AF threshold could be a useful indicator to evaluate atrial vulnerability in patients with AF. [source]

P Wave Dispersion Predicts Recurrence of Paroxysmal Atrial Fibrillation in Patients with Atrioventricular Nodal Reentrant Tachycardia Treated with Radiofrequency Catheter Ablation

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2006
Basri Amasyali M.D.
Background: Paroxysmal atrial fibrillation (AF) recurs in up to one-third of patients with atrioventricular nodal reentrant tachycardia (AVNRT) treated with slow pathway ablation. Therefore, identification of patients at risk for recurrence of AF after slow pathway ablation is important because of the necessity for additional therapies. The purpose of this study was to determine whether successful slow pathway ablation influences P wave parameters and whether these parameters predict the recurrence of paroxysmal AF in patients with both AVNRT and paroxysmal AF after ablation. Methods: Thirty-six patients with AVNRT and documented paroxysmal AF (Group 1) were compared to 36 age-matched controls with AVNRT only (Group 2). P wave durations and P dispersion were measured before and after ablation. Results: No significant differences were observed between P wave parameters observed before and after ablation. Maximum P wave durations (Pmax) and P dispersion (Pdisp) were significantly higher in Group 1 than in Group 2 (P < 0.001 for both) whereas minimum P wave durations did not differ between groups, both before and after ablation. Ten patients (28%) in Group-1 had recurrence of AF during a mean follow-up of 34 ± 11 months. Univariate predictors of AF recurrence were Pdisp ,35.5 ms (P < 0.010), left atrial diameter >40 mm (P < 0.010), mitral or aortic calcification (P < 0.010), Pmax ,112 ms (P < 0.050), valvular heart disease (P < 0.050), and atrial vulnerability (induction of AF lasting >30 second) after ablation (P < 0.050). However, only Pdisp ,35.5 ms (P < 0.050) and left atrial diameter >40 mm (P < 0.010) were independent predictors of AF recurrences. Conclusion: This study suggests that P wave dispersion could identify patients with AVNRT susceptible to recurrence of AF after slow pathway ablation. [source]