کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2924173 1175897 2009 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Left atrial remodeling in patients with atrial septal defects
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Left atrial remodeling in patients with atrial septal defects
چکیده انگلیسی

BackgroundInformation regarding left atrial (LA) substrate in conditions predisposing to atrial fibrillation (AF) is limited.ObjectiveThis study sought to characterize the left atrial remodeling that results from chronic atrial stretch caused by atrial septal defect (ASD).MethodsEleven patients with hemodynamically significant ASDs and 12 control subjects were studied. The following were evaluated using multipolar catheters: effective refractory period (ERP) at 7 sites, P-wave duration (PWD), conduction time, and inducibility of AF. LA electroanatomic maps were created to determine atrial activation, and regional conduction and voltage abnormalities.ResultsPatients with ASDs showed significant LA enlargement (P <0.001), unchanged or prolonged atrial ERPs, increase in LA conduction times (P = 0.03), prolonged PWD (P <0.001), regional conduction slowing (P <0.001), greater number of double potentials or fractionated electrograms (P <0.0001), reduced atrial voltage (P <0.001), and more frequent electrical scar (P = 0.005) compared with control subjects. In addition, patients with ASDs showed a greater propensity for sustained AF with single extrastimuli (4 of 11 vs. 0 of 12, P = 0.04).ConclusionASDs are associated with chronic left atrial stretch, which results in remodeling characterized by LA enlargement, loss of myocardium, and electrical scar that results in widespread conduction abnormalities but with no change or an increase in ERP. These abnormalities were associated with a greater propensity for sustained AF.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Heart Rhythm - Volume 6, Issue 7, July 2009, Pages 1000–1006
نویسندگان
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