scholarly journals Histological and Biochemical Characteristics in Right Atrium vs. Left Atrium in Patients with Valvular Atrial Fibrillation

2011 ◽  
Vol 27 (Supplement) ◽  
pp. OP44_4
Author(s):  
Jae Hyung Park ◽  
Sak Lee ◽  
Han Ki Park ◽  
Boyoung Jeoung ◽  
Moon Hyung Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Right Atrium ◽  
Biochemical Characteristics

scholarly journals Termination of atrial fibrillation during pharmacological cardioversion in the goat requires inter-atrial synchronisation of conduction

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
V Sobota ◽  
A Van Hunnik ◽  
S Zeemering ◽  
G Gatta ◽  
D Opacic ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Left Atrium ◽  
Conduction Velocity ◽  
Right Atrium ◽  
Path Length ◽  
Cycle Length ◽  
Final Phase ◽  
Periodic Activity ◽  
Bachmann’S Bundle

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): ITN Networks PersonalizeAF: Personalized Therapies for Atrial Fibrillation. A Translational Approach, No. 860974; CATCH ME: Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly, No. 633196; MAESTRIA: Machine Learning and Artificial Intelligence for Early Detection of Stroke and Atrial Fibrillation, No. 965286; AFib-TrainNet: EU Training Network on Novel Targets and Methods in Atrial Fibrillation, No. 675351 Netherlands Heart Foundation: CVON2014-09, RACE V Reappraisal of Atrial Fibrillation: Interaction between hyperCoagulability, Electrical remodeling, and Vascular Destabilization in the Progression of Atrial Fibrillation Background Few studies report on mechanisms leading to termination of atrial fibrillation (AF). Purpose To characterise electrophysiological parameters and conduction patterns during the transition from AF to sinus rhythm under various conditions of AF termination. Methods A retrospective evaluation of 6 goat studies was performed. AF was maintained for 3-4 weeks in 29 animals. Four animals were in SR. Unipolar electrograms were acquired with one 249-electrode array/atrium. Pharmacological termination of AF was evoked by various drugs; AP14145 (n = 5), PA6 (n = 7), XAF-1407 (n = 9) vernakalant (n = 8). In animals with sinus rhythm, AF was acutely induced and terminated spontaneously. Baseline AF and ≤3 recordings of the last 10 seconds preceding AF termination were analysed. Intervals with temporal continuous and periodic activity were distinguished in the recordings. AF cycle length (AFCL), conduction velocity and path length were determined for each interval. Results In total, 85 AF terminations were recorded. Switches between temporal continuous and periodic activity were seen frequently during AF. However, termination of AF was always preceded by a phase of periodic activity (PA). The final phase of PA persisted for a median number of 21 [IQR 10-28] cycles in the left atrium and somewhat shorter in the right atrium, Table 1. This final phase of PA was accompanied by a profound bi-atrial increase of AFCL, conduction velocity and path length and a disappearance of inter-atrial cycle length differences. Equipotent changes were not observed in the preceding PAs. During the final AF beats, the number of wave fronts were low, 1 or 2. Interestingly, 92% of the patterns during the last beats of AF involved the Bachmann’s bundle as main source of atrial conduction. Conclusion AF termination is preceded by an increased organisation of fibrillatory conduction, associated with abrupt prolongation of the path length. Propagation in atrial free walls regularly originated from the Bachmann’s bundle. These findings suggest that AF termination was not a random process but follows common spatiotemporal patterns. Final period of temporal organisation Left atrium Right atrium Final PA start Final PA end Final PA start Final PA end Af cycle length (ms) 163 ± 37 204 ± 50* 146 ± 44 207 ± 49* Conduction velocity (cm/s) 77 ± 15 96 ± 25* 83 ± 20 103 ± 24* Path Length (cm) 12.2 ± 2.7 19.3 ± 6.3* 12.0 ± 4.1 21.2 ± 6.4* Length of final periodic activity (beats) NA 21 [IQR 10-28] NA 15 [IQR 10- 25] Electrophysiological changes during the final period periodic activity (PA). Wilcoxon signed rank test. *p <0.05NA= not available

scholarly journals Histological and Biochemical Comparisons between Right Atrium and Left Atrium in Patients with Mitral Valvular Atrial Fibrillation

2014 ◽  
Vol 44 (4) ◽  
pp. 233 ◽  
Author(s):  
Jae Hyung Park ◽  
Jihei Sara Lee ◽  
Young-Guk Ko ◽  
Seung Hyun Lee ◽  
Beom Seob Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Right Atrium

Final results from the EU focal impulse and rotor modulation (E-FIRM) registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
P Sommer ◽  
S Spitzer ◽  
J Brachmann ◽  
G Janssen ◽  
C Lenz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Right Atrium ◽  
Full Potential ◽  
Rf Ablation ◽  
Private Company ◽  
Single Procedure ◽  
History Of ◽  
The Right ◽  
Af Recurrence

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Abbott Background The exact pathophysiology of how pulmonary vein (PV) triggers initiate or maintain episodes of atrial fibrillation (AF) has been elusive. Catheter ablation at relatively circumscribed areas of rapidly spinning rotors or very rapid focal impulse formation can significantly affect AF. Targeted ablation of these sources using Focal Impulse and Rotor Modulation (FIRM™) shows promise. Purpose To assess the safety and effectiveness of FIRM-guided procedures for the treatment of any type of symptomatic atrial fibrillation (AF). Methods Two hundred and ninety-nine subjects were enrolled in the E-FIRM Registry at 9 clinical sites in Germany and the Netherlands. Subjects were eligible if they had reported incidence of at least 2 documented episodes of symptomatic AF during the preceding 3 months and had failed at least Class I or III anti-arrhythmia drug. Data was collected at enrollment/baseline, procedure, and at 3-, 6-, and 12-month follow-up visits. Results A majority (59.5%, 178/299) had a history of previous ablation, 81.1% (133/164) in the left side, with an average of 1.5 ± 0.8 [range 0, 5] prior ablations. The primary safety endpoint was defined as freedom from procedure related Serious Adverse Events (SAEs) through 7-days and at 12-months. At 7-days, freedom from procedure related SAEs was 94.8% (257/271). At 12-months, freedom from procedure related SAEs was 84.4% (184/218). There were no deaths. Acute effectiveness success, defined as the elimination of all identified rotors, occurred in 64.0% (165/258) of treated patients. All patients for which data was reported had at least 1 rotor identified. The most common regions to find rotors were the lateral wall of the right atrium, the anterior/septal wall of the left atrium, and the posterior inferior region of the left atrium. 75.2% (194/258) of patients had at least one rotor identified in the right atrium, and 84.1% (217/258) of patients had at least one rotor identified in the left atrium. Success was defined as two sequential endpoints: single procedure freedom from AF recurrence at 3-months and single procedure freedom from AF recurrence. At 12-months, success was achieved in 46.4% (13/28) Paroxysmal, 42.9% (87/203) Persistent, and 0% (0/9) Long Standing AF subjects. Conclusions: Since acute success was reported as being achieved in only ∼2/3 of the treated subjects, it is possible that the full potential benefit of the FIRM-guided ablation was hidden in this evaluation of the full cohort. Considering the previous ablation and disease history of subjects, a single-procedure success rate at 12-months over 40% was considered a positive result. Based on these results, FIRM-guided RF ablation in conjunction with conventional RF ablation practices is both a safe and effective treatment strategy for patients with symptomatic AF.

Abstract 18756: Focal Impulse and Rotor Mapping (FIRM): Analysis of Basket Electrode-endocardial Proximity

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Siva Kumar R Soma ◽  
Donald R Siddoway ◽  
Raveen Bazaz ◽  
Andrew Voigt ◽  
Sandeep Jain ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Right Atrium ◽  
High Quality ◽  
Af Ablation ◽  
Basket Catheter ◽  
Surface Contact ◽  
Atrial Electrograms ◽  
Endocardial Surface

Introduction/Hypothesis: Reports of outcomes of atrial fibrillation (AF) ablation guided by FIRM have thus far been promising. FIRM maps are derived from atrial electrograms acquired using a 64 electrode “basket” catheter. There are significant discrepancies between atrial endocardial and basket geometries, and we sought to analyze individual basket electrode-endocardial proximities. Methods: In 13 patients with persistent AF undergoing FIRM-guided ablation, extensive fast anatomical mapping of right (RA, N=10) and/or left (LA, N=9) atria using the CARTO™ system (Biosense) yielded comprehensive, high quality endocardial geometries. Basket location projected within these geometries permitted assessment of endocardial proximity of each basket electrode. Proximity was defined as “near” (within 5 mm of nearest endocardial surface), “distant” (5-10 mm), and “very distant” (>10 mm). In analyzing proximity status of groups of electrodes which comprised observed rotors, “uniform near” was defined as all electrodes within 5 mm of endocardium, “mixed” was defined as some electrodes within 5 mm and others beyond 5 mm, and “uniform far” as all electrodes beyond 5 mm. Results: Right atrium: Among 10 patients, 54% of electrodes were near, 22% of electrodes were distant, and 24% of electrodes were very distant. Among 15 discrete rotors observed in 7 patients, 6 (40%) were uniform near, 8 (53%) were mixed, and 1 (7%) was uniform far. Left Atrium: Among 9 patients, 53% of electrodes were near, 24% of electrodes were distant, and 23% of electrodes were very distant. Among 17 discrete rotors observed in 9 patients, 8 (47%) were uniform near, 9 (53%) were mixed, and none were uniform far. Conclusions: Electrodes used to construct FIRM maps are commonly distant from the endocardial surface. Contact heterogeneity is common among groups of electrodes comprising rotors. The implications of these observations for use and utility of the basket-derived FIRM technique are unclear.

Nonreentrant focal activations in pulmonary veins in canine model of sustained atrial fibrillation

2002 ◽  
Vol 283 (3) ◽  
pp. H1244-H1252 ◽  
Author(s):  
Shengmei Zhou ◽  
Che-Ming Chang ◽  
Tsu-Juey Wu ◽  
Yasushi Miyauchi ◽  
Yuji Okuyama ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Right Atrium ◽  
Cycle Length ◽  
Pulmonary Veins ◽  
Posterior Wall ◽  
Canine Model ◽  
Anterior Wall ◽  
High Density ◽  
The Right

Repetitive rapid activities are present in the pulmonary veins (PVs) in dogs with pacing-induced sustained atrial fibrillation (AF). The mechanisms are unclear. We induced sustained (>48 h) AF by rapidly pacing the left atrium (LA) in six dogs. High-density computerized mapping was done in the PVs and atria. Results show repetitive focal activations in all dogs and in 12 of 18 mapped PVs. Activation originated from the middle of the PV and then propagated to the LA and distal PV with conduction blocks. The right atrium (RA) was usually activated by a single large wavefront. Mean AF cycle length in the PVs (left superior, 82 ± 6 ms; left inferior, 83 ± 6 ms; right inferior, 83 ± 4 ms) and LA posterior wall (87 ± 5 ms) were significantly ( P < 0.05) shorter than those in the LA anterior wall (92 ± 4 ms) and RA (107 ± 5 ms). PVs in normal dogs did not have focal activations during induced AF. No reentrant wavefronts were demonstrated in the PVs. We conclude that nonreentrant focal activations are present in the PVs in a canine model of pacing-induced sustained AF.

P402Analysis of right atrium remodeling by cardiac magnetic resonance in patients with atrial fibrillation and its association with left atrium

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Gunturiz Beltran ◽  
R Borras-Amoraga ◽  
F Alarcon ◽  
P Garre ◽  
R Figueras ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Healthy Volunteers ◽  
Left Atrium ◽  
Right Atrium ◽  
Cox Regression ◽  
Structural Heart Disease ◽  
Moderate Correlation ◽  
Arrhythmogenic Substrate

Abstract Funding Acknowledgements none Background Atrial fibrillation (AF) causes changes in atrial anatomy and this remodeling leads to the arrhythmogenic substrate. Most studies with cardiac magnetic resonance-late gadolinium enhancement (CMR-LGE) have focused on the left atrium (LA); The role of the right atrium (RA) in AF is unknown. Purpose To evaluate RA remodeling parameters and its comparison with LA in patients with AF. Methods Observational study. We included 109 patients: 9 healthy volunteers, 55 paroxysmal AF, 45 persistent AF. All of them had a CMR-RTG 3.0 T. Image post-processed with segmentation of both atria. Comparison of mean parameters of RA and LA (T test), correlation between them (R Pearson). Multivariate analysis (Cox regression) to study predictive factors. Results AF patients had a mean age of 58.5 ± 10.5 years, 70(70%) were men, without structural heart disease 80(80%), and associated atrial flutter 11(11%). The RA parameters were compared by subgroups. We found differences in (healthy/paroxAF/persistAF): area(cm2) 94.0 ± 15.9 /125.3 ± 20.8/ 152.8 ± 24.4 (p &lt;0.0001); volume (ml) 76.7 ± 19.6/ 107.0 ± 25.6/ 150.9 ± 37.6 (p &lt;0.0001); and total fibrosis (%) 3.7 ± 4.3/ 16.5 ± 14.1/ 19.4 ± 15.9 (p 0.014). RA was higher than LA in all subgroups. There was more fibrosis in RA in paroxysmal/persistent AF. Both types of AF had at least a moderate correlation for area, volume and fibrosis (table). Finally, RA sphericity was the only predictor factor of AF recurrence after ablation among RA remodeling parameters (HR 1.1 95%CI [1.0 -1.3], p = 0.049). Conclusions Area, volume and fibrosis progressively increased from healthy to paroxysmal AF, and then to persistent AF. RA was higher than LA and it also had more fibrosis in patients with AF. The size and fibrosis between both atria had at least moderate correlation. The RA sphericity was a predictor of post-ablation AF recurrences. COMPARISON/CORRELATION RA LA p R PEARSON(RA/LA) p HEALTHY VOLUNTEERS Volume (ml) 76.7 ± 19.6 37.0 ± 9.4 &lt;0.0001 0.457 0.254 Total Fibrosis (%) 3.7 ± 4.3 5.0 ± 6.1 0.278 0.837 0.005 PAROXYSMAL AF Volume (ml) 107.0 ± 25.6 69.5 ± 26.5 &lt;0.0001 0.422 0.001 Total Fibrosis (%) 16.5 ± 14.1 8.0 ± 8.6 &lt;0.0001 0.485 &lt;0.0001 PERSISTENT AF Volume (ml) 150.9 ± 37.6 103.2 ± 28.5 &lt;0.0001 0.582 &lt;0.0001 Total Fibrosis (%) 19.4 ± 15.9 10.5 ± 11.7 &lt;0.0001 0.571 &lt;0.0001 Abstract Figure. Correlation of area and fibrosis RA/LA

scholarly journals The effect of hemodialysis on echocardiographic parameters and on supraventricular cardiac arrhythmias

2020 ◽  
Vol 11 (3) ◽  
pp. 29-34
Author(s):  
Oleg V. Likhachev-Mishchenko ◽  
Alexey A. Kornienko ◽  
Larisa A. Khaisheva ◽  
Anastasia V. Duzhikova ◽  
Natalia A. Kornienko ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Dialysis Session ◽  
Supraventricular Arrhythmias ◽  
Before And After ◽  
Echocardiographic Parameters ◽  
The Right

Relevance. Supraventricular arrhythmias are frequent comorbid conditions in patients with end-stage renal failure undergoing dialysis. The prevalence of atrial fibrillation (AF) in this group of patients is higher than in the general population and is associated with increased mortality. Aim. To analyze the effect of a dialysis session on echocardiographic parameters and to assess their relationship with the occurrence of supraventricular arrhythmias and AF during hemodialysis. Material and methods. The study included 78 patients on hemodialysis. All patients underwent Holter electrocardiography monitoring, taking into account the heart rate before and after dialysis, the number and duration of AF episodes associated with the dialysis session. Using echocardiography, which was performed before and after the dialysis procedure, all patients were also evaluated for the presence of left ventricular (LV) hypertrophy, impaired systolic and diastolic function, as well as LV myocardial mass, sizes of the left atrium, its volume, volume of the right atrium and LV ejection fraction. Results. An analysis of the differences in echocardiographic parameters before and after dialysis showed a significantly larger volume of the left atrium, the volume of the right atrium, the width of the inferior vena cava, and the parameter P(early transmitral velocity) before dialysis compared with the state after dialysis. Also, AF paroxysms were recorded much more frequently after dialysis. The volume of the left atrium 32 mm and the right atrium 30 mm (limit values) were observed much more often in patients before dialysis. A relationship was found between an increased number of paroxysms of atrial fibrillation and a decrease in the volume of the right atrium 5 mm and the left atrium 7 mm after dialysis. No correlation was found between the mass of the LV and the volume of the left atrium. Conclusions. 1. The age and duration of dialysis therapy in hemodialysis patients are associated with an increased risk of atrial fibrillation. 2. A decrease in the volumes of the right and left atriums after the hemodialysis procedure has a positive correlation with paroxysmal AF. 3. The hemodialysis procedure leads to a decrease in the volumes of the right and left atriums, as well as the width of the inferior vena cava and a decrease in the speed of movement of the mitral valve in early diastole. 4. No relationship was found between the volume of the left atrium and the mass of the LV myocardium in patients on hemodialysis.

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