Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/533
Título: Inducibility of Atrial Fibrillation During Electrophysiologic Evaluation is Associated with Increased Dispersion of Atrial Refractoriness
Autor: Oliveira, MM
Nogueira da Silva, M
Timóteo, AT
Feliciano, J
Sousa, L
Santos, S
Silva-Carvalho, L
Cruz Ferreira, R
Palavras-chave: Fibrilhação Auricular
Seio Coronário
Aurícula do Coração
Sistema de Condução Cardíaco
Septo Cardíaco
Modelos Logísticos
Análise Multivariada
Valor Preditivo dos Testes
Período Refractário Electrofisiológico
Índice de Gravidade da Doença
Data: 2009
Editora: Elsevier
Citação: Int J Cardiol. 2009 Aug 14;136(2):130-5
Resumo: The impact of atrial dispersion of refractoriness (Disp_A) in the inducibility and maintenance of atrial fibrillation (AF) has not been fully resolved. AIM: To study the Disp_A and the vulnerability (A_Vuln) for the induction of self-limited (<60 s) and sustained episodes of AF. METHODS AND RESULTS: Forty-seven patients with paroxysmal AF (PAF): 29 patients without structural heart disease and 18 with hypertensive heart disease. Atrial effective refractory period (ERP) was assessed at five sites--right atrial appendage and low lateral right atrium, high interatrial septum, proximal and distal coronary sinus. We compared three groups: group A - AF not inducible (n=13); group B - AF inducible, self-limited (n=18); group C - AF inducible, sustained (n=16). Age, lone AF, hypertension, left atrial and left ventricular (LV) dimensions, LV systolic function, duration of AF history, atrial flutter/tachycardia, previous antiarrhythmics, and Disp_A were analysed with logistic regression to determine association with A_Vuln for AF inducibility. The ERP at different sites showed no differences among the groups. Group A had a lower Disp_A compared to group B (47+/-20 ms vs 82+/-65 ms; p=0.002), and when compared to group C (47+/-20 ms vs 80+/-55 ms; p=0.008). There was no significant difference in Disp_A between groups B and C. By means of multivariate regression analysis, the only predictor of A_Vuln was Disp_A (p=0.04). Conclusion: In patients with PAF, increased Disp_A represents an electrophysiological marker of A_Vuln. Inducibility of both self-limited and sustained episodes of AF is associated with similar values of Disp_A. These findings suggest that the maintenance of AF is influenced by additional factors.
Peer review: yes
URI: http://hdl.handle.net/10400.17/533
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