Premium
Double atrial potentials in left‐sided accessory pathways are associated with paroxysmal atrial fibrillation
Author(s) -
Błaszyk Krzysztof,
Gwizdała Adrian,
Waśniewski Michał,
Hiczkiewicz Jarosław,
Seniuk Wojciech,
Michalak Michał
Publication year - 2018
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/jce.13347
Subject(s) - medicine , atrioventricular reentrant tachycardia , cardiology , atrial fibrillation , coronary sinus , tachycardia , accessory pathway , qrs complex , atrium (architecture) , electrophysiology , paroxysmal atrial fibrillation , catheter ablation
Muscular connections between the coronary sinus (CS) and left atrium probably impact distribution of electrical activity. Double atrial potentials (DP) may be their presentation. The aim was to investigate the presence of DP in CS recordings during atrioventricular reentrant tachycardia (AVRT) and its contribution to the occurrence of paroxysmal atrial fibrillation (AF). Methods A group of 247 patients with accessory pathways (AP) were screened for DP. The patients with DP during AVRT were compared to those without DP. Results DP during AVRT were found only among the left‐sided AP (AP‐L). Patients with AP‐L were divided into Group 1 (n = 17) with DP during AVRT and Group 2 (n = 108) without DP. Patients in Group 1 had higher incidence of AF in history (47.1% vs. 23.1%; P = 0.0376), AF induced during electrophysiological (EP) study (70.6% vs. 25%; P = 0.0002). Group 1 had higher heart rate (HR) during AVRT in the EP study (197.2 ± 27 vs. 175.1 ± 26.3 bpm; P = 0.0019), but HR of clinical AVRT (208.5 ± 30.8 vs. 191.6 ± 27.8 bpm) was not significant different (P = ns). Additionally, electrical alternans of QRS amplitude during AVRT in the EP study was more frequent in Group 1 (52.9 vs. 20.4 %; P = 0.0048). Conclusion Patients with DP and AP‐L were more prone to develop AF. The presence of DP was associated with faster AVRT rate. The direction of atrium depolarization during AVRT may be different in the presence of DP and probably plays a role in development of AF in this group of patients.