Susceptibility to atrial fibrillation: a study in an ovine model of pacing-induced early heart failure.
BACKGROUND
The development of susceptibility to atrial fibrillation (AF) is a common consequence of many forms of cardiovascular disease, especially heart failure. In this study we used a sheep model of pacing-induced stable early heart failure to describe, quantify, and relate the level of susceptibility to AF to changes in structural and electrophysiologic parameters.


RESULTS
Epicardial electrodes were implanted on the atria and right ventricles of nine sheep. The AF threshold, atrial vulnerability period, atrial effective refractory period (ERP), and interatrial conduction time were examined during control and over a 6-week period of ventricular pacing at 190 beats/min. Left atrial (LA) area and left ventricular (LV) fractional shortening were monitored using echocardiography. There were significant increases in LA susceptibility to AF (P < 0.0003), LA area (P < 0.0002), and LA ERP400 (P < 0.0002). Rate of increase in LA area was related positively to AF susceptibility (P = 0.02) and inversely to LA ERP400 (P = 0.002). LV fractional shortening decreased to approximately 50% of control value (P < 0.00001). No changes were observed in right atrial electrophysiology.


CONCLUSIONS
In this study, susceptibility (the ability of an extrastimulus to induce AF) was rigorously measured within a predetermined format. Significant relationships were found to exist between susceptibility, certain of the observed changes in atrial electrophysiology and structure.
Power
J M
JM
Department of Medicine, University of Melbourne, Heidelberg, Australia. jmp@austin.unimelb.edu.au
Beacom
G A
GA
Alferness
C A
CA
Raman
J
J
Wijffels
M
M
Farish
S J
SJ
Burrell
L M
LM
Tonkin
A M
AM
D000818:Animals; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D004594:Electrophysiology; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D011930:Reaction Time; D012756:Sheep; D014463:Ultrasonography