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Comparison of left atrial electrophysiologic abnormalities during sinus rhythm in patients with different type of atrial fibrillation

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Abstract

Objective

The purpose of this study is to explore the left atrium (LA) electrophysiologic abnormalities in atrial fibrillation (AF) patients detected during sinus rhythm and to determine the relationship between the type of AF and the electrophysiologic substrate in the LA.

Methods

Eighty patients with AF (30 paroxysmal AF, 22 persistent AF, and 28 long-standing AF) and 20 age- and sex-matched patients with left-sided accessory pathway were prospectively studied. High-density three-dimensional electroanatomic mapping was performed during sinus rhythm in LA, which was divided into six segments for regional analysis. Mean bipolar voltage, low voltage zone (LVZ) distribution, LA activation time, and electrogram complexity were assessed.

Results

The LA mean voltage was 3.67 ± 0.68 mV in no AF group, 2.16 ± 0.63 mV in the paroxysmal, 1.81 ± 0.36 mV in the persistent, and 1.48 ± 0.34 mV in the long-standing AF patients (P < 0.001). The total LA activation time was 75.3 ± 5.4 ms in no AF, 89.7 ± 12.3 ms in paroxysmal AF, 104.9 ± 6.1 ms in persistent AF, and 115.6 ± 12.1 ms in the long-standing AF patients, respectively (P < 0.001). With the progression of AF, there was a higher incidence of LVZ detection and increased prevalence of complex electrograms with 95 % of complex electrograms in areas with the bipolar voltage ≤ 1.3 mV in persistent and long-standing AF patients.

Conclusion

Patients with AF have abnormal electrophysiologic substrate in sinus rhythm characterized by lower mean bipolar voltage, more prevalent complex electrograms, and longer LA activation time. This substrate progresses parallel to progression of AF type.

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Fundings

This work was supported by the Program for Development of Innovative Research Team in the First Affiliated Hospital of Nanjing Medical University, People’s Republic of China (IRT-004) and the Project of National Scientific Fund Committee (81070156), People’s Republic of China

Competing interests

None

Author information

Authors and Affiliations

  1. Cardiology Division, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China

    Yazhou Lin, Bing Yang, Weizhu Ju, Fengxiang Zhang, Hongwu Chen, Jinbo Yu, Mingfang Li, Kai Gu, Kejiang Cao & Minglong Chen

  2. Electrophysiology Section, Cardiovascular Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Fermin C. Garcia, David J. Callans & Francis E. Marchlinski

Authors
  1. Yazhou Lin
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  2. Bing Yang
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  3. Fermin C. Garcia
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  4. Weizhu Ju
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  5. Fengxiang Zhang
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  6. Hongwu Chen
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  7. Jinbo Yu
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  8. Mingfang Li
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  9. Kai Gu
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  10. Kejiang Cao
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  11. David J. Callans
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  12. Francis E. Marchlinski
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  13. Minglong Chen
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Corresponding author

Correspondence to Minglong Chen.

Additional information

Drs. Yazhou Lin and Bing Yang contributed equally to literature search, data collection, data analysis, data interpretation, and writing. Dr. Fermin Garcia contributed to data analysis and data interpretation. Drs. Weizhu Ju, Fengxiang Zhang, Hongwu Chen, and Jinbo Yu contributed to data collection. Dr. Kejiang Cao was responsible for data interpretation. Drs. David Callans and Francis Marchlinski were responsible for study design and language polishing. Dr. Minglong Chen was the corresponding author who contributed to the conception and study design, writing, and final approval of the version to be submitted.

Authors Yazhou Lin and Bing Yang had equal contribution to this work.

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Lin, Y., Yang, B., Garcia, F.C. et al. Comparison of left atrial electrophysiologic abnormalities during sinus rhythm in patients with different type of atrial fibrillation. J Interv Card Electrophysiol 39, 57–67 (2014). https://doi.org/10.1007/s10840-013-9838-y

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  • DOI: https://doi.org/10.1007/s10840-013-9838-y

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