Local Capture by Atrial Pacing in Spontaneous Chronic Atrial Fibrillation

Pandozi, Claudio; Bianconi, Leopoldo; Villani, M; Castro, Antonio; Altamura, Giuliano; Toscano, Salvatore; Jesi, Anna Patrizia; G, Gentilucci; Ammirati, Fabrizio; Bianco, Francesco; Santini, Massimo

doi:10.1161/01.cir.95.10.2416

Cited by 39 publications

(24 citation statements)

References 15 publications

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“…23 Third, our results are limited to types I and AF and may not account for type III or IV AF, because of the high dissociation of activation and highly fragmented atrial electrograms. 24 Fourth, because the RPAF was only measured in the lateral wall of the LA, it remains unknown whether the atrial refractoriness during AF develops differently in other areas such as the right atrium, Bachmann's bundle or the area between the pulmonary veins.…”

Section: Study Limitationsmentioning

confidence: 99%

Role of Progressive Widening of the Temporal Excitable Gap for Perpetuation of Atrial Fibrillation in the Goat

Shan

Yan

Jun-yan

et al. 2010

Circ J

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Background: Previous studies suggest that a short temporal excitable gap exists between the fibrillation waves during atrial fibrillation (AF). The aim of this study was to investigate the role of that gap in the development of sustained AF in goats. Methods and Results:Eight female goats were instrumented with left atrium (LA) electrodes, and sustained AF (>24 h) was induced by intermittent rapid atrial pacing for 9.3±4.6 days. In the process of sustained AF development, the atrial effective refractory period (AERP), refractory period during AF (RPAF), mean AF cycle length (AFCL), temporal excitable gap during AF (EGAF = AFCL − RPAF) and degree of fractionation of fibrillation electrograms at LA were studied. When the induced AF lasted for 3-10 min, AFCL, RPAF and EGAF were 98.3±11.0 ms, 90.5±13.2 ms and 7.8±2.4 ms, respectively. During sustained AF, the values were 84.9±5.2 ms, 63.0±4.8 ms and 21.9±3.5 ms, respectively (P<0.05). Percentage of single potentials was 94.2±3.9% and 75.6±5.5%, respectively (P<0.05). Conclusions:In this model progressive shortening of atrial refractoriness and widening of the temporal excitable gap induced by electrical remodeling created an electrophysiologic substrate for the perpetuation of AF. (Circ J 2010; 74: 655 - 663)

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Section: Study Limitationsmentioning

confidence: 99%

Role of Progressive Widening of the Temporal Excitable Gap for Perpetuation of Atrial Fibrillation in the Goat

Shan

Yan

Jun-yan

et al. 2010

Circ J

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“…9 Conversely, entrainment of AF is not always feasible during type III AF. [11][12][13] Statistical comparison of the AFCL histogram during synchronized premature stimuli is a highly objective way to determine the RP AF . It is a rather complex technique, however, requiring specific expertise.…”

Section: Comparison Of Different Techniques To Measure Rp Afmentioning

confidence: 99%

Methods for Determining the Refractory Period and Excitable Gap During Persistent Atrial Fibrillation in the Goat

et al. 2001

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Background-Recently, the temporal excitable gap during atrial fibrillation (AF) has been identified as a vulnerable parameter for cardioversion of AF. In this study, we evaluated 5 methods to measure the refractory period (RP AF ) and the excitable period (EP AF ) during persistent AF. Methods and Results-In 11 goats instrumented with 83 epicardial atrial electrodes, persistent AF (43Ϯ34 days) was induced with a median AF cycle length (CL) of 98Ϯ14 ms. To measure RP AF , premature stimuli were applied to the center of the electrode array on the right or left atrium. The RP AF measured by mapping of premature stimuli was 70Ϯ12 ms ("gold standard"

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“…Obtaining capture in both atria was found possible only when pacing in the septum, although the ability to sustain capture was low. Modeling results confirmed that single site rapid pacing of AF cannot terminate acute nor permanent AF [28,29].…”

Section: Pacing Of Afmentioning

confidence: 62%

“…As compared to electrical cardioversion, pacing of AF has the advantage of being painless, safe and energy-efficient. While the possibility of local atrial capture by rapid pacing has been demonstrated in animals and humans [28,29], no pacing therapy has proved so far to be effective in terminating AF. This is probably due to the complex dynamics, the variable number of propagation wavefronts and the small and variable excitable gap observed during AF.…”

Section: Pacing Of Afmentioning

confidence: 99%

Modeling of Atrial Fibrillation

Virag¹,

Jacquemet²,

Kappenberger³

2012

Cardiac Mapping

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Computer modeling of atrial fibrillation (AF) is considered today as a potentially effective tool for better understanding AF mechanisms and for the development of therapeutic options. Computer models are based on an integrative approach, from the molecule to the patient, incorporating data about cell electrophysiology, cell-to-cell coupling and atrial anatomy. The link to clinical experiments is provided by the computation of endocardial electrograms or surface electrocardiograms (ECG). In this chapter we describe how modeling can be used to study different forms of AF and to evaluate therapies such as antiarrhythmic drugs, ablation and antitachycardia pacing. The ultimate goal is the development of patient-specific models in order to test AF therapies in the model before applying it to the patient.

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Local Capture by Atrial Pacing in Spontaneous Chronic Atrial Fibrillation

Cited by 39 publications

References 15 publications

Role of Progressive Widening of the Temporal Excitable Gap for Perpetuation of Atrial Fibrillation in the Goat

Role of Progressive Widening of the Temporal Excitable Gap for Perpetuation of Atrial Fibrillation in the Goat

Methods for Determining the Refractory Period and Excitable Gap During Persistent Atrial Fibrillation in the Goat

Modeling of Atrial Fibrillation

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