Electrical Remodeling of the Atria Associated With Paroxysmal and Chronic Atrial Flutter

• DOI: 10.1161/01.cir.102.15.1807
• Publication Date: 2012-06-12T00:42:29Z
• Authors: Paul B. Sparks; Shenthar Jayaprakash; Jitendra K. Vohra; Jonathan M. Kalman
• Keywords: Male; Middle Aged; Electrophysiology; 03 medical and health sciences; 0302 clinical medicine; Atrial Flutter; Atrial Fibrillation; Chronic Disease; Catheter Ablation; Humans; Female; Heart Atria; Prospective Studies; Aged

Background —Atrial electrical remodeling may be important for the initiation and perpetuation of atrial arrhythmias. Whether paroxysmal flutter (AFL) chronic AFL cause atria has not been conclusively determined. Methods Results —Before radiofrequency ablation AFL, 15 patients in sinus rhythm were evaluated under autonomic blockade. Lateral right (LRA) effective refractory periods (ERPs) at 600 450 ms measured before 1-minute intervals 10 minutes after spontaneous or pace termination a 5- to 10-minute period induced AFL. In with LRA, septal, coronary (CS) ERPs corrected node recovery times (cSNRTs) blockade minutes, 30 3 weeks by ablation. group, LRA decreased 18% 12% ( P <0.01) recovered baseline over ≈5 minutes. Atrial fibrillation developed during ERP testing when refractoriness was its nadir. CS significantly greater than both cycle lengths <0.01). Three ablation, cSNRT 35% <0.05) 44% <0.05). Both cSNRTs different. Conclusions —Both reversible but demonstrate different time courses recovery.