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Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data
BACKGROUND: We evaluated the effect of adenosine upon mechanisms sustaining persistent AF through analysis of contact electrograms and ECGI mapping. METHODS: Persistent AF patients undergoing catheter ablation were included. ECGI maps and cycle length (CL) measurements were recorded in the left and...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993562/ https://www.ncbi.nlm.nih.gov/pubmed/33765054 http://dx.doi.org/10.1371/journal.pone.0248951 |
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author | Dhillon, Gurpreet Singh Ahluwalia, Nikhil Honarbakhsh, Shohreh Graham, Adam Creta, Antonio Abbass, Hakam Chow, Anthony Earley, Mark J. Lambiase, Pier D. Schilling, Richard J. Hunter, Ross J. |
author_facet | Dhillon, Gurpreet Singh Ahluwalia, Nikhil Honarbakhsh, Shohreh Graham, Adam Creta, Antonio Abbass, Hakam Chow, Anthony Earley, Mark J. Lambiase, Pier D. Schilling, Richard J. Hunter, Ross J. |
author_sort | Dhillon, Gurpreet Singh |
collection | PubMed |
description | BACKGROUND: We evaluated the effect of adenosine upon mechanisms sustaining persistent AF through analysis of contact electrograms and ECGI mapping. METHODS: Persistent AF patients undergoing catheter ablation were included. ECGI maps and cycle length (CL) measurements were recorded in the left and right atrial appendages and repeated following boluses of 18 mg of intravenous adenosine. Potential drivers (PDs) were defined as focal or rotational activations completing ≥ 1.5 revolutions. Distribution of PDs was assessed using an 18 segment biatrial model. RESULTS: 46 patients were enrolled. Mean age was 63.4 ± 9.8 years with 33 (72%) being male. There was no significant difference in the number of PDs recorded at baseline compared to adenosine (42.1 ± 15.2 vs 40.4 ± 13.0; p = 0.417), nor in the number of segments harbouring PDs, (13 (11–14) vs 12 (10–14); p = 0.169). There was a significantly higher percentage of PDs that were focal in the adenosine maps (36.2 ± 15.2 vs 32.2 ± 14.4; p < 0.001). There was a significant shortening of CL in the adenosine maps compared to baseline which was more marked in the right atrium than left atrium (176.7 ± 34.7 vs 149.9 ± 27.7 ms; p < 0.001 and 165.6 ± 31.7 vs 148.3 ± 28.4 ms; p = 0.003). CONCLUSION: Adenosine led to a small but significant shortening of CL which was more marked in the right than left atrium and may relate to shortening of refractory periods rather than an increase in driver burden or distribution. Registered on Clinicaltrials.gov: NCT03394404. |
format | Online Article Text |
id | pubmed-7993562 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-79935622021-04-05 Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data Dhillon, Gurpreet Singh Ahluwalia, Nikhil Honarbakhsh, Shohreh Graham, Adam Creta, Antonio Abbass, Hakam Chow, Anthony Earley, Mark J. Lambiase, Pier D. Schilling, Richard J. Hunter, Ross J. PLoS One Research Article BACKGROUND: We evaluated the effect of adenosine upon mechanisms sustaining persistent AF through analysis of contact electrograms and ECGI mapping. METHODS: Persistent AF patients undergoing catheter ablation were included. ECGI maps and cycle length (CL) measurements were recorded in the left and right atrial appendages and repeated following boluses of 18 mg of intravenous adenosine. Potential drivers (PDs) were defined as focal or rotational activations completing ≥ 1.5 revolutions. Distribution of PDs was assessed using an 18 segment biatrial model. RESULTS: 46 patients were enrolled. Mean age was 63.4 ± 9.8 years with 33 (72%) being male. There was no significant difference in the number of PDs recorded at baseline compared to adenosine (42.1 ± 15.2 vs 40.4 ± 13.0; p = 0.417), nor in the number of segments harbouring PDs, (13 (11–14) vs 12 (10–14); p = 0.169). There was a significantly higher percentage of PDs that were focal in the adenosine maps (36.2 ± 15.2 vs 32.2 ± 14.4; p < 0.001). There was a significant shortening of CL in the adenosine maps compared to baseline which was more marked in the right atrium than left atrium (176.7 ± 34.7 vs 149.9 ± 27.7 ms; p < 0.001 and 165.6 ± 31.7 vs 148.3 ± 28.4 ms; p = 0.003). CONCLUSION: Adenosine led to a small but significant shortening of CL which was more marked in the right than left atrium and may relate to shortening of refractory periods rather than an increase in driver burden or distribution. Registered on Clinicaltrials.gov: NCT03394404. Public Library of Science 2021-03-25 /pmc/articles/PMC7993562/ /pubmed/33765054 http://dx.doi.org/10.1371/journal.pone.0248951 Text en © 2021 Dhillon et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Dhillon, Gurpreet Singh Ahluwalia, Nikhil Honarbakhsh, Shohreh Graham, Adam Creta, Antonio Abbass, Hakam Chow, Anthony Earley, Mark J. Lambiase, Pier D. Schilling, Richard J. Hunter, Ross J. Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data |
title | Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data |
title_full | Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data |
title_fullStr | Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data |
title_full_unstemmed | Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data |
title_short | Impact of adenosine on mechanisms sustaining persistent atrial fibrillation: Analysis of contact electrograms and non-invasive ECGI mapping data |
title_sort | impact of adenosine on mechanisms sustaining persistent atrial fibrillation: analysis of contact electrograms and non-invasive ecgi mapping data |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993562/ https://www.ncbi.nlm.nih.gov/pubmed/33765054 http://dx.doi.org/10.1371/journal.pone.0248951 |
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