title: Distinctive electrophysiological properties of pulmonary veins in patients with atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is frequently initiated from pulmonary veins (PVs), but little is known of the electrophysiological properties of PVs.
  
  
  RESULTS
  Two groups were studied: 28 patients (49+/-13 years old) with paroxysmal AF and 20 control patients (49+/-14 years old) without AF. Effective and functional refractory period and conduction time from PV to left atrium (LA) were compared in the 2 groups by use of programmed stimulation with a single extrastimulus in the PVs and LA. In the AF group, the venous effective refractory periods (ERPs) were shorter than that of the LA: 185+/-71 versus 253+/-21 ms, P<0.001, whereas in the control group, they were longer (282+/-45 versus 253+/-41 ms, P=0.009). The venous ERPs and functional refractory periods in patients with AF were also shorter than that observed in control subjects (185+/-71 versus 282+/-45 ms and 210+/-77 versus 315+/-43 ms, respectively, P<0.001), whereas LA ERPs were not significantly different. Decremental conduction in PVs was more frequent (93% versus 56%, P=0.01) and had a greater increment (102+/-65 versus 42+/-40 ms, P<0.001) in patients with AF. Finally, AF was more frequently induced when pacing was performed in PVs (22 of 90) versus LA (1 of 81) in patients with AF (P<0.001).
  
  
  CONCLUSIONS
  The PVs of patients with AF exhibited distinctive electrophysiological properties, which were strikingly different from those of patients devoid of AF, potentially explaining their arrhythmogenicity.
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France. pierre.jais@ph.u-bordeaux2.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Laurent
authors.initials: L
authors.lastname: Macle
authors.forename: Kee-Joon
authors.initials: KJ
authors.lastname: Choi
authors.forename: Isabel
authors.initials: I
authors.lastname: Deisenhofer
authors.forename: Rukshen
authors.initials: R
authors.lastname: Weerasooriya
authors.forename: Dipen C
authors.initials: DC
authors.lastname: Shah
authors.forename: Stéphane
authors.initials: S
authors.lastname: Garrigue
authors.forename: Florence
authors.initials: F
authors.lastname: Raybaud
authors.forename: Christophe
authors.initials: C
authors.lastname: Scavee
authors.forename: Philippe
authors.initials: P
authors.lastname: Le Metayer
authors.forename: Jacques
authors.initials: J
authors.lastname: Clémenty
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery; D002304:Cardiac Pacing, Artificial / Q000379:methods; D017115:Catheter Ablation; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology*; D011930:Reaction Time