Reverse atrial electrical remodeling induced by cardiac resynchronization therapy

Interatrial block as a predictor of atrial fibrillation in patients with ST‐segment elevation myocardial infarction

“…In the present study, the prevalence of IAB decreased from 51.5% to 23.7% after revascularization. Although it is widely accepted that IAB is the result of atrial fibrosis, reversed electrical remodeling was observed in patients with obstructive sleep apnea syndrome and advanced heart failure after cardiac resynchronization therapy . We can speculate that successful revascularization ameliorated the devastating effects of myocardial ischemia on conduction properties of the atrium.…”

“…Although it is widely accepted that IAB is the result of atrial fibrosis, reversed electrical remodeling was observed in patients with obstructive sleep apnea syndrome 24 and advanced heart failure after cardiac resynchronization therapy. 25 We can speculate that successful revascularization ameliorated the devastating effects of myocardial ischemia on conduction properties of the atrium. In addition, hyperadrenergic state and increased left atrial filling pressures that are encountered during the acute phase of STEMI could contribute to the conduction heterogeneity in the atrial myocardium and caused development of IAB.…”

P‐wave and interatrial block: New predictor for atrial high rate episodes in patients with cardiac implantable electronic devices

“…Finally, we have documented that patients with AHRE and without prior paroxysmal AF also had longer P‐wave duration (130 ± 25 ms vs 115 ± 17 ms; P < 0.001), and IAB prevalence (52% vs 27%, respectively; P < 0.001). This is particularly relevant to predict future episodes of AF in patients without previous clinical documentation of this arrhythmia and highlights the importance of the P‐wave duration and the IAB presence before CIED implantation…”

Latest Insights into Mechanisms behind Atrial Cardiomyopathy: It Is Not always about Ventricular Function

“…A study including a total of 41 patients who received a de novo CRT implantation revealed that the P-wave duration measured in the surface 12-lead ECG significantly decreased following CRT therapy (at least 12 months since implantation and with adequate bi-ventricular pacing > 92% of the time). This is an important clue regarding the therapeutic potential use of CRT in patients with ACM because the prolongation of the P-wave duration represents a quantitative indirect marker for atrial electrical remodeling [61].…”