The Effects of Pulmonary Vein Isolation on the Morphology of P Waves: The Contribution of Pulmonary Vein Muscle Excitation to the Formation of P Waves

Date, Taro; Yamane, Teiichi; Inada, Keiichi; Matsuo, Seiichiro; Kanzaki, Yasuko; Miyanaga, Satoru; Shibayama, Kentaro; Miyazaki, Hidekazu; Sugimoto, Kunihisa; Taniguchi, Ikuo; Mochizuki, Seibu

doi:10.1111/j.1540-8159.2007.00570.x

Cited by 24 publications

(14 citation statements)

References 12 publications

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“…This would correlate with the different findings of Ogawa et al and Date et al wherein they found reduction and no change, respectively, in the width of the P wave after CPVI during long-term follow-up. 7,8 The decrease in the LA activation time due to earlier propagation of the medial wave front seen in 24% of our patients would explain the reduction in the width of the P wave as observed by Ogawa et al 7 …”

Section: La Activation Pattern and Timingsmentioning

confidence: 57%

“…Numerous studies have demonstrated some varying effects of PV isolation (PVI) on the P-wave duration in the electrocardiogram (ECG), atrial size, LA function and activation. [7][8][9][10] Successful PVI was reported to significantly reduce the LA size on long-term follow-up. 9 Increased LA activation times are observed in patients who underwent repeat procedure after PVI.…”

Section: Introductionmentioning

confidence: 97%

“…10 Ogawa et al found a significant reduction in the P-wave duration after PVI, while this finding was not observed by Date et al using different methodology. 7,8 However, data on the immediate effect of PVI on LA substrate are still limited. The aim of this study was to investigate the acute effect of CPVI on LA activation, LA voltage, and P-wave amplitude in surface ECG, and correlate with the clinical outcome.…”

Section: Introductionmentioning

confidence: 99%

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Acute Effect of Circumferential Pulmonary Vein Isolation on Left Atrial Substrate

Udyavar¹,

Huang

Chang

et al. 2009

Cardiovasc electrophysiol

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Section: La Activation Pattern and Timingsmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Acute Effect of Circumferential Pulmonary Vein Isolation on Left Atrial Substrate

Udyavar¹,

Huang

Chang

et al. 2009

Cardiovasc electrophysiol

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“…The VCG may also be applied to the study of atrial loops. Date et al [22] could identify the role of the cardiac tissue surrounding the pulmonary veins in the formation of the P wave and thus the changes that pulmonary vein isolation …”

Section: The Vectorcardiogrammentioning

confidence: 99%

“…However, the standard ECG does not provide spatial information that can be obtained with a vectorcardiogram (VCG). The VCG allows the observation of the contribution of a specific tissue region on the morphology of P waves after isolation of the pulmonary veins [22] and spatial parameters derived from the VCG constitute a risk factor in post myocardial infarction patients [4]. Also, the study of the VCG during AF allows the extraction of spatial characteristics of AF waves that have been related to the organization of the atrial activity during AF [102].…”

Section: Introductionmentioning

confidence: 99%

Activation patterns in atrial fibrillation: contributions of body surface potential mapping.

Sanchez¹,

Salud²

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A mi padre AgradecimientosQuiero expresar mi agradecimiento a todas las personas que me han apoyado durante la realización de esta tesis doctoral y que han sido muchas.A mi madre y a mi tía, que no sólo me han apoyado anímicamente durante la realización de esta tesis, sino que sin su ayuda, aguja e hilo en mano, sus ideas y su trabajo ni siquiera hubiera podido comenzar a desarrollar esta tesis.A mis directores de tesis Pepe Millet y Paco Castells. A Pepe quiero agradecerle la confianza que siempre ha depositado en mí y el haberme apoyado siempre en todo lo que le ha sido posible durante estos anos. A Paco quiero agradecerle su ayuda durante laúltima etapa de la realización de la tesis y especialmente su meticulosidad en la redacción científica que tanto ha mejorado la calidad de mi trabajo.A los doctores Javier Chorro y Vicent Bodí del Hospital Clínico Universitario de Valencia. Ellos fueron los primeros en dedicarme su tiempo y permitirme tomar registros en su consulta con la ayuda de los entonces residentes Mauricio Pellicer y Lorena Peiró.Al doctor Steven Swiryn y al profesor Alan Sahakian por haberme permitido trabajar con ellos en su grupo en la Northwestern University en EEUU. Ellos supieron transmitirme su dinamismo, su entrega a la investigación y de ellos he aprendido cómo poner en práctica el método científico desde la planificación del trabajo hasta la presentación de resultados.Al doctor Andreas Bollmann y a la doctora Daniela Husser del Hospital de Leipzig en Alemania por haber creído en mi proyecto y haberse involucrado activamente en mi investigación desde la toma registros a los pacientes de su hospital al diseno de los estudios o colaboración en la difusión de resultados.Al doctor Aurelio Quesada del Hospital General de Valencia con quien estamos colaborando actualmente poniendo en práctica los métodos desarrollados en esta tesis. Conél, además de llevar a cabo proyectos muy prometedores, es todo un placer colaborar gracias a su inquietud científica y a su calidad humana.Al doctor Ramón Brugada, con el que he tenido el honor poder colaborar y con el que espero poder tener el honor de seguir colaborando en el futuro. Coń el no sólo estoy teniendo la posibilidad de realizar investigación puntera en el campo de la cardiología, sino que también he tenido la oportunidad de conocer iii iv AGRADECIMIENTOS a un científico ejemplar y una persona excepcional.A los pacientes y voluntarios que han participado en los estudios que han dado lugar a esta tesis y que han tenido que soportar con paciencia que les llenara el cuerpo de cables y cintas de una forma totalmente desinteresada. Sin ellos no me hubiera sido posible desarrollar esta tesis.A los que han sido mis companeros de laboratorio desde que empecé a interesarme por la investigación durante la realización de mi proyecto final de carrera y que tanto me animaron en los momentos difíciles: Fili, Pepelu, Natalia, Diego, Cibeles, Robin, Vicente, David, Laura, José Antonio y también a todos los que han formado parte del grupo de investigación durante todo...

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The impact of left atrial pressure on filtered P-wave duration in patients with atrial fibrillation

et al. 2016

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The cause of prolonged filtered P-wave duration (FPD) remains unclear in atrial fibrillation (AF) patients with normal left atrial size. We investigated whether FPD is associated with left atrial pressure (LAP) in AF patients without prominent LA enlargement. This study included 80 patients (48 men, age 65 ± 9 years, 25 persistent AF) with non-valvular AF who underwent catheter ablation (CA) for AF. LAP was measured in sinus rhythm during CA and signal-averaged electrocardiogram was recorded after CA. We retrospectively assessed the clinical and echocardiographic variables. Prolonged FPD was defined as FPD > 120 ms. Prolonged FPD (FPD > 120 ms) was detected in 23/80 patients (29 %). According to univariate analysis, higher mean LAP (14.9 ± 4.4 vs. 10.8 ± 3.5 mmHg, p < 0.0001), higher prevalence of persistent arrhythmia, higher BNP, larger LAD, higher E wave, and lower LVEF were associated with Prolonged FPD. According to multivariate analysis, higher mean LAP was the only factor associated with Prolonged FPD (p = 0.0058, OR 1.256 for each 1 mmHg increase in mean LAP, 95 % CI 1.068-1.476). Moreover, a significant correlation was observed between FPD and mean LAP (r = 0.503, p < 0.0001). Prolonged FPD is associated with high LAP in AF patients without prominent left atrial enlargement. Pressure overload of the left atria might cause slowing of atrial electrical activation.

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The Effects of Pulmonary Vein Isolation on the Morphology of P Waves: The Contribution of Pulmonary Vein Muscle Excitation to the Formation of P Waves

Abstract: The excitation of cardiac muscle tissue, which has migrated to the pulmonary veins, was thus found to play an important role in the formation of the middle part of the P wave/loop.

Cited by 24 publications

References 12 publications

Acute Effect of Circumferential Pulmonary Vein Isolation on Left Atrial Substrate

Acute Effect of Circumferential Pulmonary Vein Isolation on Left Atrial Substrate

Activation patterns in atrial fibrillation: contributions of body surface potential mapping.

The impact of left atrial pressure on filtered P-wave duration in patients with atrial fibrillation

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