Electrophysiologic properties of atrial muscle in paroxysmal atrial fibrillation

Hashiba, Kunitake; Tanigawa, Muneo; Fukuda, Masahiko; Shimizu, Akihiko; Konoe, Atsushi; Kadena, Mitsuo; Mori, Mitsuhiro

doi:10.1016/0002-9149(89)91192-2

Cited by 56 publications

(35 citation statements)

References 7 publications

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“…1 It was reported that prolonged intra-and interatrial conduction and inhomogeneous propagation of sinus impulses would be the characteristics of paroxysmal atrial fibrillation (PAF) during sinus rhythm. 2,3 Filtered P-wave analysis has an advantage in detecting atrial electrophysiologic abnormalities in developing PAF. 4,5 Decreased A-velocity is correlated with reduced atrial contraction.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Atrial Electromechanical Coupling and Influential Factors in Nonrheumatic Paroxysmal Atrial Fibrillation

Cui

Zhang

Wang

et al. 2008

Clinical Cardiology

125

153

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SummaryBackground: Sequential analysis of atrial electromechanical coupling (P-A) by Doppler tissue imaging (DTI) might provide important insight into the mechanisms of paroxysmal atrial fibrillation (PAF).Hypothesis: The purpose of this study was to evaluate P-A and the dispersion of P-A, and to analyze the influential factors of P-A.Methods: One hundred and ten patients with PAF and 87 normal controls were enrolled. Using DTI, the time intervals from the beginning of P-wave to the onset of atrioventricular ring motion related to atrial contraction were measured.Results: Atrial electromechanical coupling at the interventricular septum atrioventricular annulus (P-A1), left lateral mitral annulus (P-A2) and right lateral tricuspid annulus (P-A3) in PAF group were significantly longer than those in control (p<0.001). The difference between P-A2 and P-A1 (T1), P-A2 and P-A3 (T3) in PAF group were greater than those in control before age correction (p<0.05). The linear regression analysis showed that the

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Section: Introductionmentioning

confidence: 99%

Assessment of Atrial Electromechanical Coupling and Influential Factors in Nonrheumatic Paroxysmal Atrial Fibrillation

Cui

Zhang

Wang

et al. 2008

Clinical Cardiology

125

153

View full text Add to dashboard Cite

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“…[24][25][26] An intra-atrial conduction delay, measured from the stimulus artifact to the atrial electrogram at the distal coronary sinus level, reflects an actual intra-atrial conduction delay that is not influenced by local latency at the site of stimulation. [27][28][29] The conduction velocity of a premature atrial depolarization decreases when it encounters a period of incomplete recovery of excitability. This slowing in conduction may set the background for reentry to occur.…”

Section: Figurementioning

confidence: 99%

“…Although an increase of 20 ms or more in the atrial conduction time in response to early extrastimulus appears to be a physiological response of the normal atrium, patients with nonidiopathic PAF show longer atrial CD zones and maximum atrial CD than control subjects without atrial arrhythmias. [27][28][29] Thus, the atrial CD zone and maximum CD are believed to be good indices of a tendency to develop AF. We showed in this study that these indices were also significantly greater in patients with lone PAF than in control subjects.…”

Section: Figurementioning

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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“…Clinical studies have focused mainly on the electrophysiological properties of the substrate in the atrial muscle during sinus rhythm and on the atrial electrical responses elicited by premature stimulation method. [6][7][8][9] However, many fundamental aspects of this arrhythmia have been poorly understood until quite recently, and there are several features on the mechanisms of AF that makes it difficult to manage it properly. Increasing awareness of AF as a disease with possible fatal complications rather than as an acceptable alternative to sinus rhythm has led to search for clear arguments to support a certain strategy as a golden standard.…”

Section: Introductionmentioning

confidence: 99%

Dabigatran, a direct thrombin inhibitor, in atrial fibrillation: Is it already time for a change in oral anticoagulation therapy?

Centurión¹

2010

J.A.F.I.B

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Atrial fibrillation (AF) is a common arrhythmia, and its prevalence increases with aging and the severity of heart disease. AF affects more than 2 million people in the US, and more than 4 million in Europe. It is expected that the age adjusted prevalence in US will excede 10 million people by the year 2050. [1][2][3][4][5] In the last decade, we were able to see the light shed by several trials that dealt with AF mechanisms and the appropriate management of AF patients. Clinical studies have focused mainly on the electrophysiological properties of the substrate in the atrial muscle during sinus rhythm and on the atrial electrical responses elicited by premature stimulation method.6-9 However, many fundamental aspects of this arrhythmia have been poorly understood until quite recently, and there are several features on the mechanisms of AF that makes it difficult to manage it properly. Increasing awareness of AF as a disease with possible fatal complications rather than as an acceptable alternative to sinus rhythm has led to search for clear arguments to support a certain strategy as a golden standard.There is no atrial contraction during AF, a situation that renders the pooled blood inside the atrium susceptible to develop thrombus formation particularly in the left atrium. AF increases the overall risk of stroke five-fold, and is associated with particularly severe strokes .10-12 About 76% of AF patients have a moderate to high risk of embolic complications, and they have also a significant risk factor for stroke recurrence. [13][14][15] It looks very clear that all the difficulties we have to face in finding proper answer to its therapeutic management. Vitamin K antagonist drugs, such as warfarin and acenocumarol, reduce the risk of AF-related stroke by about 70%. 4,16 They are the only oral antico agulants currently recommended for the prevention of stroke in patients with a moderate to high risk of stroke 15 These pharmacological agents produce their anticoagulant effect by preventing the g-carboxylation of the vitamin K-dependent coagulation factors prothrombin and Factors VII, IX, and X.17 Despite the good clinical results obtained with these oral anticoagulants that are far from being ideal [ Table 1], there are some inconvenient factors which make their conventional use difficult to implement and follow. There is a consistent suboptimal utilization of oral anticoagulation therapy. Warfarin is prescribed to only two thirds of appropriate candidates despite guidelines recommendations. 18 The narrow therapeutic window in the anticoagulation process makes it neccessary to monitor closely the prothrombin time. Insufficient

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Electrophysiologic properties of atrial muscle in paroxysmal atrial fibrillation

Cited by 56 publications

References 7 publications

Assessment of Atrial Electromechanical Coupling and Influential Factors in Nonrheumatic Paroxysmal Atrial Fibrillation

Assessment of Atrial Electromechanical Coupling and Influential Factors in Nonrheumatic Paroxysmal Atrial Fibrillation

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

Dabigatran, a direct thrombin inhibitor, in atrial fibrillation: Is it already time for a change in oral anticoagulation therapy?

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