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Prolonged Atrial Effective Refractory Periods in Atrial Fibrillation Patients Associated with Structural Heart Disease or Sinus Node Dysfunction Compared with Lone Atrial Fibrillation

Authors
 JAE-SUN UHM  ;  HEE-SUN MUN  ;  JIN WI  ;  JAEMIN SHIM  ;  BOYOUNG JOUNG  ;  MOON-HYOUNG LEE  ;  HUI-NAM PAK 
Citation
 PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol.36(2) : 163-171, 2013 
Journal Title
 PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 
ISSN
 0147-8389 
Issue Date
2013
MeSH
Atrial Fibrillation/diagnosis* ; Atrial Fibrillation/epidemiology* ; Comorbidity ; Electrocardiography/statistics & numerical data* ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Assessment ; Sick Sinus Syndrome/diagnosis* ; Sick Sinus Syndrome/epidemiology* ; Ventricular Dysfunction, Left/diagnosis* ; Ventricular Dysfunction, Left/epidemiology*
Keywords
Atrial Fibrillation/diagnosis* ; Atrial Fibrillation/epidemiology* ; Comorbidity ; Electrocardiography/statistics & numerical data* ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Assessment ; Sick Sinus Syndrome/diagnosis* ; Sick Sinus Syndrome/epidemiology* ; Ventricular Dysfunction, Left/diagnosis* ; Ventricular Dysfunction, Left/epidemiology*
Abstract
BACKGROUNDS: Atrial fibrillation (AF) is commonly associated with structural heart disease (SHD) or sinus node dysfunction (SND). We hypothesized that regional atrial effective refractory period (ERP) is different in patients with SHD/SND from lone AF. METHODS: We included 648 patients with AF (age, 56.0 ± 11.0 years; male, 77.3%; paroxysmal AF [PAF], 67.9%; persistent AF [PeAF], 32.1%) who underwent radiofrequency catheter ablation (RFCA), and compared the clinical characteristics in patients with SHD (n = 132) versus without SHD (n = 516) and those with SND (n = 74) versus without SND (n = 574). ERPs were measured at the high and low right atrium, proximal, and distal coronary sinus. RESULTS: (1) Patients with SHD had older age (P < 0.001), greater left atrial (LA) volume (P < 0.001), LA pressure (P = 0.002), and plasma proatrial natriuretic peptide (P = 0.005) than patients without SHD. (2) Patients with SND were older (P = 0.004), more likely female (P = 0.004), and had lower body weight (P < 0.001) and higher E/E' (P < 0.001) than those without SND. (3) The mean atrial ERP was significantly shorter in patients with PeAF than those with PAF (P < 0.001). The mean ERP was significantly longer in patients with AF with SHD/SND than those with lone AF (P = 0.006). (4) The clinical outcomes of RFCA were not significantly different between SHD/SND and lone AF for 14.8 ± 8.5 months of follow-up period. CONCLUSION: The mean atrial ERP was shorter in patients with PeAF than those with PAF due to electrical remodeling. In contrast, AF patients with SHD/SND showed a more prolonged mean atrial ERP than those with lone AF, associated with LA enlargement or left ventricular diastolic dysfunction.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/pace.12037/abstract
DOI
10.1111/pace.12037
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Mun, Hee Sun(문희선)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Shim, Jae Min(심재민)
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Wi, Jin(위진) ORCID logo https://orcid.org/0000-0003-0655-5130
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86887
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