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The Early Stage of the Atrial Electroanatomic Remodeling as Substrates for Atrial Fibrillation in Hypertensive Patients

BACKGROUND: Hypertension is one of the most important risk factors for atrial fibrillation (AF). Recent studies suggest right atrial remodeling in hypertensive patients may be associated with increased inducibility of AF. This study sought to characterize the electroanatomic features of left and rig...

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Autores principales: Yin, Xiaomeng, Zhao, Yan, Xi, Yutao, Cheng, Nancy, Xia, Yunlong, Zhang, Shulong, Dong, Yingxue, Chang, Dong, Cheng, Jie, Yang, Yanzong, Gao, Lianjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323835/
https://www.ncbi.nlm.nih.gov/pubmed/25237045
http://dx.doi.org/10.1161/JAHA.114.001033
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author Yin, Xiaomeng
Zhao, Yan
Xi, Yutao
Cheng, Nancy
Xia, Yunlong
Zhang, Shulong
Dong, Yingxue
Chang, Dong
Cheng, Jie
Yang, Yanzong
Gao, Lianjun
author_facet Yin, Xiaomeng
Zhao, Yan
Xi, Yutao
Cheng, Nancy
Xia, Yunlong
Zhang, Shulong
Dong, Yingxue
Chang, Dong
Cheng, Jie
Yang, Yanzong
Gao, Lianjun
author_sort Yin, Xiaomeng
collection PubMed
description BACKGROUND: Hypertension is one of the most important risk factors for atrial fibrillation (AF). Recent studies suggest right atrial remodeling in hypertensive patients may be associated with increased inducibility of AF. This study sought to characterize the electroanatomic features of left and right atria and pulmonary veins (PVs) in hypertensive patients. METHODS AND RESULTS: A prospective observational study was conducted on patients who underwent ablation for paroxysmal supraventricular tachycardia or paroxysmal AF. Electrophysiological features of the PVs and atria, including event‐related potentials, conduction time, and inducibility and vulnerability of AF, were characterized during cardiac catheterization. Anatomic and hemodynamic features were assessed by using echocardiographic and computer tomography imaging. When 15 hypertensive patients with paroxysmal supraventricular tachycardia were compared with 17 normotensive patients with paroxysmal supraventricular tachycardia, the hypertensive patients had significantly shortened PV event‐related potentials with increased dispersions (P<0.001) but slightly prolonged atrial event‐related potentials (P=NS) and had prolonged interatrial and intra‐atrial conduction times (P<0.001). Additionally, the hypertensive patients had increased vulnerability and inducibility of AF and prolonged duration of induced AF (P<0.01). All of these changes were more pronounced in hypertensive patients with paroxysmal AF. Anatomically, compared with the normotensive patients, the diameters of 4 PVs in the hypertensive patients with paroxysmal supraventricular tachycardia were significantly enlarged (P<0.01) and became more remarkable in hypertensive patients with paroxysmal AF (P<0.0001), although the diameter and volume index of the left atrium among 3 groups were similar. CONCLUSIONS: The hypertensive patients showed electroanatomic changes associated with increased vulnerability to AF, including shortened event‐related potentials with increased dispersion, prolonged conduction time, and increased PV diameter, but these changes were not appreciated in the atria. Additionally, these changes became more dramatic in hypertensive patients with paroxysmal AF.
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spelling pubmed-43238352015-02-23 The Early Stage of the Atrial Electroanatomic Remodeling as Substrates for Atrial Fibrillation in Hypertensive Patients Yin, Xiaomeng Zhao, Yan Xi, Yutao Cheng, Nancy Xia, Yunlong Zhang, Shulong Dong, Yingxue Chang, Dong Cheng, Jie Yang, Yanzong Gao, Lianjun J Am Heart Assoc Original Research BACKGROUND: Hypertension is one of the most important risk factors for atrial fibrillation (AF). Recent studies suggest right atrial remodeling in hypertensive patients may be associated with increased inducibility of AF. This study sought to characterize the electroanatomic features of left and right atria and pulmonary veins (PVs) in hypertensive patients. METHODS AND RESULTS: A prospective observational study was conducted on patients who underwent ablation for paroxysmal supraventricular tachycardia or paroxysmal AF. Electrophysiological features of the PVs and atria, including event‐related potentials, conduction time, and inducibility and vulnerability of AF, were characterized during cardiac catheterization. Anatomic and hemodynamic features were assessed by using echocardiographic and computer tomography imaging. When 15 hypertensive patients with paroxysmal supraventricular tachycardia were compared with 17 normotensive patients with paroxysmal supraventricular tachycardia, the hypertensive patients had significantly shortened PV event‐related potentials with increased dispersions (P<0.001) but slightly prolonged atrial event‐related potentials (P=NS) and had prolonged interatrial and intra‐atrial conduction times (P<0.001). Additionally, the hypertensive patients had increased vulnerability and inducibility of AF and prolonged duration of induced AF (P<0.01). All of these changes were more pronounced in hypertensive patients with paroxysmal AF. Anatomically, compared with the normotensive patients, the diameters of 4 PVs in the hypertensive patients with paroxysmal supraventricular tachycardia were significantly enlarged (P<0.01) and became more remarkable in hypertensive patients with paroxysmal AF (P<0.0001), although the diameter and volume index of the left atrium among 3 groups were similar. CONCLUSIONS: The hypertensive patients showed electroanatomic changes associated with increased vulnerability to AF, including shortened event‐related potentials with increased dispersion, prolonged conduction time, and increased PV diameter, but these changes were not appreciated in the atria. Additionally, these changes became more dramatic in hypertensive patients with paroxysmal AF. Blackwell Publishing Ltd 2014-09-18 /pmc/articles/PMC4323835/ /pubmed/25237045 http://dx.doi.org/10.1161/JAHA.114.001033 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Yin, Xiaomeng
Zhao, Yan
Xi, Yutao
Cheng, Nancy
Xia, Yunlong
Zhang, Shulong
Dong, Yingxue
Chang, Dong
Cheng, Jie
Yang, Yanzong
Gao, Lianjun
The Early Stage of the Atrial Electroanatomic Remodeling as Substrates for Atrial Fibrillation in Hypertensive Patients
title The Early Stage of the Atrial Electroanatomic Remodeling as Substrates for Atrial Fibrillation in Hypertensive Patients
title_full The Early Stage of the Atrial Electroanatomic Remodeling as Substrates for Atrial Fibrillation in Hypertensive Patients
title_fullStr The Early Stage of the Atrial Electroanatomic Remodeling as Substrates for Atrial Fibrillation in Hypertensive Patients
title_full_unstemmed The Early Stage of the Atrial Electroanatomic Remodeling as Substrates for Atrial Fibrillation in Hypertensive Patients
title_short The Early Stage of the Atrial Electroanatomic Remodeling as Substrates for Atrial Fibrillation in Hypertensive Patients
title_sort early stage of the atrial electroanatomic remodeling as substrates for atrial fibrillation in hypertensive patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323835/
https://www.ncbi.nlm.nih.gov/pubmed/25237045
http://dx.doi.org/10.1161/JAHA.114.001033
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