RT-77
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Is there an anatomically
distinct pattern of atrial electrograms in patients with paroxysmal atrial fibrillation?
Goette atrial electrograms during atrial fibrillation
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Andreas Goette, J. Christoph
Geller, Wolfgang M. Hartung, Angelo Auricchio, Hans-Dieter Esperer, Helmut U. Klein.
Department of Internal Medicine, Division of Cardiology, University Hospital
Magdeburg, Magdeburg, Germany
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Abstract
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Recent studies have speculated about a specific
anatomic distribution of effective refractory periods (ERP) and atrial electrograms during
atrial fibrillation in animal models. The purpose of this study was to characterize atrial
electrograms at different atrial sites in patients with and without a history of
spontaneous atrial fibrillation.
Methods. Twelve patients (9 male, 3 female; 54 ± 16 years) were
examined during their routine electrophysiologic study. Six patients had no history of
atrial fibrillation (group 1), the remaining 6 patients had paroxysmal atrial fibrillation
(group 2). The atrial ERP was determined at a basic cycle length of 450 ms in the high
right atrium (HRA), the low right atrium (LRA), the right atrial appendage (RAA) and in
the distal coronary sinus (dCS). Thereafter, atrial fibrillation was induced by burst
pacing, and bipolar electrograms (5 mm electrode interspace) were simultaneously recorded
at all sites.
Results. The baseline ERPs at different sites were not signific-antly
different between the two groups. There was a trend towards longer ERPs in the LRA and the
dCS in both groups. The duration of induced atrial fibrillation was significantly longer
in group 2 (1.3 ± 1 min vs 8.9 ± 5 min; p < 0.05). There was no difference in the
mean fibrillatory cycle length (AFCL) or the variation of AFCL at different recording
sites within groups or between group 1 and 2. No specific anatomic distribution of
electrograms according to atrial fibrillation types I, II or III could be demonstrated in
the two groups.
Conclusions. There is no specific anatomic distribution of local
bipolar electrograms during induced AF in humans. This is in contrast to the observed
anatomically distinct pattern of local electrograms during chronic atrial fibrillation in
animal models.
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Key Words
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Atrial fibrillation
paroxysmal atrial fibrillation, anatomic patterns, bipolar electrogram patterns, atrial
effective refractory period, OA
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