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Wavelength and Conduction Inhomogeneity in Each Atrium in Patients with Isolated Mitral Valve Disease and Atrial Fibrillation
Author(s) -
NITTA TAKASHI,
IMURA HAJIME,
BESSHO RYUZOU,
HOSAKA HIROKI,
YAMAUCHl SHIGEO,
TANAKA SHIGEO
Publication year - 1999
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1999.tb00708.x
Subject(s) - medicine , cardiology , atrial fibrillation , atrium (architecture) , coronary sinus , mitral valve , left atrium , sinus rhythm , interatrial septum
AF in Mitral Valve Disease. Introduction : Patients with mitral valve disease frequently have atrial fibrillation (AF), and the left atrium is presumed to be the primary atrium that develops AF. However, it is still not clear whether the electrophysiologic abnormalities responsible for AF are confined to the left atrium in this subset of patients. Methods and Results : To examine the AF vulnerability of each atrium, we measured the wavelength and in homogeneity of the conduction at the lateral right atrium, lateral left atrium, and Bachmann's bundle after defibrillation of AF in seven patients undergoing the maze procedure and mitral valve surgery for AF and isolated mitral valve disease, respectively (AF group). The data were compared with five coronary surgery patients in sinus rhythm (SR group). The wavelength in the AF group was significantly shorter (P < 0.05) than in the SR group not only at the lateral left atrium (225 ± 62 vs 285 ± 36 mm) but also at the lateral right atrium (214 ± 54 vs 254 ± 34 mm). The variation coefficient of the local maximum activation phase difference in the AF group (1.9 ± 0.8 at the right atrium, 2.1 ± 0.8 at the lateral left atrium, and 2.0 ± 0.6 at Bachmann's bundle) was significantly greater (P < 0.05) than in the SR group at all atrial regions. Conclusion : AF vulnerability was not confined to the left atrium immediately after defibrillation in AF patients with isolated mitral valve disease. Electrical remodeling resulting from perpetuation of AF, pathological changes extending to the right atrium, geometric changes caused by the atrial interactions occurring across the interatrial septum, or a combination of these may explain the results.