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Article: Effects of simultaneous atrioventricular pacing on atrial refractoriness and atrial fibrillation inducibility: Role of atrial mechanoelectrical feedback

TitleEffects of simultaneous atrioventricular pacing on atrial refractoriness and atrial fibrillation inducibility: Role of atrial mechanoelectrical feedback
Authors
Issue Date2001
PublisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873
Citation
Journal Of Cardiovascular Electrophysiology, 2001, v. 12 n. 1, p. 43-50 How to Cite?
AbstractAtrial Mechanoelectrical Feedback. Introduction: The purpose of this study was to evaluate the effects of an acute increase in atrial pressure on refractoriness (mechanoelectrical feedback) and the vulnerability to atrial fibrillation (AF) and to investigate the effects of autonomic blockade and verapamil on mechanoelectrical feedback in humans. Methods and Results: Right atrial pressure and effective refractory period (ERP) at the right atrial appendage (RAA) and high right atrial septum were measured during sinus rhythm, and during atrial and simultaneous AV pacing at a cycle length of 300 msec, either in the absence (n = 25) or presence (n = 22) of pharmacologic autonomic blockade. In another 15 patients, the protocol was performed before and after infusion of verapamil 0.15 mg/kg. In the absence of autonomic blockade, AV pacing resulted in a higher mean right atrial pressure (11.7 ± 3.3 vs 4.3 ± 3.0 mmHg, P < 0,001) and a shorter atrial RAA ERP (144 ± 23 msec vs 161 ± 21 msec; P < 0.001) compared with atrial pacing; AF was induced more often during AV pacing (87%) than during atrial pacing (20%) and was related directly to the right atrial pressure (r = 0.39, P = 0.004) and indirectly to the RAA ERP (r = -0.42, P < 0.001). The susceptibility to sustained AF was greatly enhanced by autonomic blockade. Verapamil markedly attenuated the shortening of ERP and the propensity for AF that occurred during simultaneous AV pacing. Conclusion: An acute increase in atrial pressure during tachycardia is associated with shortening of atrial refractoriness and a propensity for AF, i.e., atrial mechanoelectrical feedback, which may be enhanced by autonomic blockade and attenuated by calcium channel blockade.
Persistent Identifierhttp://hdl.handle.net/10722/78151
ISSN
2015 Impact Factor: 3.097
2015 SCImago Journal Rankings: 1.863
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorPelosi, Fen_HK
dc.contributor.authorOral, Hen_HK
dc.contributor.authorKnight, BPen_HK
dc.contributor.authorStrickberger, SAen_HK
dc.contributor.authorMorady, Fen_HK
dc.date.accessioned2010-09-06T07:39:44Z-
dc.date.available2010-09-06T07:39:44Z-
dc.date.issued2001en_HK
dc.identifier.citationJournal Of Cardiovascular Electrophysiology, 2001, v. 12 n. 1, p. 43-50en_HK
dc.identifier.issn1045-3873en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78151-
dc.description.abstractAtrial Mechanoelectrical Feedback. Introduction: The purpose of this study was to evaluate the effects of an acute increase in atrial pressure on refractoriness (mechanoelectrical feedback) and the vulnerability to atrial fibrillation (AF) and to investigate the effects of autonomic blockade and verapamil on mechanoelectrical feedback in humans. Methods and Results: Right atrial pressure and effective refractory period (ERP) at the right atrial appendage (RAA) and high right atrial septum were measured during sinus rhythm, and during atrial and simultaneous AV pacing at a cycle length of 300 msec, either in the absence (n = 25) or presence (n = 22) of pharmacologic autonomic blockade. In another 15 patients, the protocol was performed before and after infusion of verapamil 0.15 mg/kg. In the absence of autonomic blockade, AV pacing resulted in a higher mean right atrial pressure (11.7 ± 3.3 vs 4.3 ± 3.0 mmHg, P < 0,001) and a shorter atrial RAA ERP (144 ± 23 msec vs 161 ± 21 msec; P < 0.001) compared with atrial pacing; AF was induced more often during AV pacing (87%) than during atrial pacing (20%) and was related directly to the right atrial pressure (r = 0.39, P = 0.004) and indirectly to the RAA ERP (r = -0.42, P < 0.001). The susceptibility to sustained AF was greatly enhanced by autonomic blockade. Verapamil markedly attenuated the shortening of ERP and the propensity for AF that occurred during simultaneous AV pacing. Conclusion: An acute increase in atrial pressure during tachycardia is associated with shortening of atrial refractoriness and a propensity for AF, i.e., atrial mechanoelectrical feedback, which may be enhanced by autonomic blockade and attenuated by calcium channel blockade.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873en_HK
dc.relation.ispartofJournal of Cardiovascular Electrophysiologyen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAnti-Arrhythmia Agents - pharmacologyen_HK
dc.subject.meshAtrial Fibrillation - etiologyen_HK
dc.subject.meshAtrial Functionen_HK
dc.subject.meshAtrioventricular Node - physiopathologyen_HK
dc.subject.meshAutonomic Nerve Blocken_HK
dc.subject.meshCardiac Pacing, Artificialen_HK
dc.subject.meshElectrophysiologyen_HK
dc.subject.meshFeedbacken_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHemodynamicsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshRefractory Period, Electrophysiologicalen_HK
dc.subject.meshVerapamil - pharmacologyen_HK
dc.titleEffects of simultaneous atrioventricular pacing on atrial refractoriness and atrial fibrillation inducibility: Role of atrial mechanoelectrical feedbacken_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1045-3873&volume=12&spage=43&epage=50&date=2001&atitle=Effects+of+simultaneous+atrioventricular+pacing+on+atrial+refractoriness+and+atrial+fibrillation+inducibility:+Role+of+atrial+mechanoelectrical+feedback.en_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid11204083-
dc.identifier.scopuseid_2-s2.0-0035143581en_HK
dc.identifier.hkuros100775en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035143581&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume12en_HK
dc.identifier.issue1en_HK
dc.identifier.spage43en_HK
dc.identifier.epage50en_HK
dc.identifier.isiWOS:000166538500009-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridPelosi, F=7004832991en_HK
dc.identifier.scopusauthoridOral, H=7006855160en_HK
dc.identifier.scopusauthoridKnight, BP=7201940628en_HK
dc.identifier.scopusauthoridStrickberger, SA=7005045293en_HK
dc.identifier.scopusauthoridMorady, F=35431764400en_HK

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