Different distribution of abnormal endocardial electrograms within the right atrium in patients with sick sinus syndrome

Centurión, Osmar Antonio; Fukuda, Masahiko; Konoe, Atsushi; Tanigawa, Muneo; Shimizu, Akihiko; Isomoto, Shojiro; Kaibara, Muneshige; Hashiba, Kunitake

doi:10.1136/hrt.68.12.596

Cited by 63 publications

(48 citation statements)

References 33 publications

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“…Therefore, abnormal electrograms indicate areas of altered anatomy and conduction that are suitable substrates for reentrant arrhythmias. 5 Since abnormal atrial electrograms increase with advancing age, these electrophysiologic changes may account for the ease with which AF can develop in elderly patients.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] It was strongly suggested that muscle loss and increase of fibrosis in the atria is a slow but continuous process starting at about 60 years of age. 3 Since aging has a profound effect on structural changes of the atrial muscle, and since fractionated atrial endocardial electrograms may reflect nonsynchronized, delayed local electrical activity through a diseased atrial muscle, 5 it seems reasonable to assume that there may be detectable age-induced changes in atrial endocardial electrograms in patients with paroxysmal atrial fibrillation (PAF). To the best of our knowl-edge, this is the first study designed to clarify the influence of advancing age on atrial endocardial electrograms recorded during sinus rhythm by means of intra-atrial catheter mapping in patients with PAF.…”

Section: Introductionmentioning

confidence: 99%

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The effects of aging on atrial endocardial electrograms in patients with paroxysmal atrial fibrillation

Centurión

Isomoto

Shimizu

et al. 2003

Clinical Cardiology

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Background: The prevalence of atrial fibrillation (AF) has been reported to increase with advancing age. Histologic studies in AF have demonstrated that the percentage of fibrosis and degenerative changes in the atrial muscle increase significantly with age. Hypothesis: This study was undertaken to assess the influence of advancing age on atrial endocardial electrograms recorded during sinus rhythm in patients with paroxysmal atrial fibrillation (PAF), which had not been assessed previously. Methods: Right atrial endocardial catheter mapping during sinus rhythm was performed in 111 patients with PAF to evaluate the influence of advancing age onatrial endocardial electrograms. The bipolar electrograms were recorded at 12 sites in the right atrium, and an abnormal atrial electrogram was defined as lasting ≥ 100 ms, and/or showing eight or more fragmented deflections. Results: In all, 1,332 right atrial endocardial electrograms were assessed and measured quantitatively. The number of abnormal atrial electrograms in patients with PAF showed a significantly positive correlation with age (r = 0.34; p<0.0005). Patients aged > 60 years had a significantly greater mean number of abnormal electrograms (2.58 ± 2.05) than those aged < 60 years (1.43 ± 2.03; p<0.004). The longest duration (r = 0.35; p<0.0005) and the maximal number of fragmented deflections (r = 0.29; p<0.005) of atrial electrograms among the 12 right atrial sites also showed a significantly positive correlation with age. Conclusions: Aging alters the electrophysiologic properties of the atrial muscle in patients with PAF. Elderly patients have a significantly greater abnormality of atrial endocardial electrograms than do younger ones. There is a progressive increment in the extension of altered atrial muscle with advancing age in patients with PAF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effects of aging on atrial endocardial electrograms in patients with paroxysmal atrial fibrillation

Centurión

Isomoto

Shimizu

et al. 2003

Clinical Cardiology

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“…Patients with diseased atrial tissue with progressive fibrodegenerative changes may develop abnormal electrophysiological alterations [7][8][9][10][11]. Connective tissue surrounding atrial myocardial cells represents sites where electrical coupling between adjacent cells is altered [1][2][3].…”

Section: Editorialmentioning

confidence: 99%

P Wave Duration and Dispersion as a Useful Conventional Electrocardiographic Marker for Atrial Fibrillation Prediction

2017

JCCR

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“…7 Since not all patients with atrial arrhythmias initiate AF, a substrate for atrial propensity to AF is required for AF initiation and maintenance. [8][9][10] Abnormal responses of the atrium can be elicited by programmed atrial stimulation, such as repetitive atrial firing, fragmented atrial activity, and intraatrial conduction delay, and have been more frequently observed in patients with nonidiopathic PAF. Shorter atrial effective refractory period has been also shown to be of electrophysiological significance in the genesis of AF.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological Changes of the Atrium in Patients with Lone Paroxysmal Atrial Fibrillation

Centurión¹,

Isomoto²,

Shimizu³

2010

J.A.F.I.B

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Introduction : Paroxysmal atrial fibrillation (PAF) is a common arrhythmia, and it is associated with various cardiac conditions. On the other hand, lone PAF has no identifiable underlying cause, and can occur any time for no apparent reason. The underlying causes may modify the electrophysiological properties of the atrium in different ways and extent. However this setting may be different in patients with lone PAF. We sought to investigate the atrial electrophysiological properties in lone PAF.

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Different distribution of abnormal endocardial electrograms within the right atrium in patients with sick sinus syndrome

Cited by 63 publications

References 33 publications

The effects of aging on atrial endocardial electrograms in patients with paroxysmal atrial fibrillation

The effects of aging on atrial endocardial electrograms in patients with paroxysmal atrial fibrillation

P Wave Duration and Dispersion as a Useful Conventional Electrocardiographic Marker for Atrial Fibrillation Prediction

Electrophysiological Changes of the Atrium in Patients with Lone Paroxysmal Atrial Fibrillation

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