Deterioration of interatrial conduction in patients with paroxysmal atrial fibrillation: electroanatomic mapping of the right atrium and coronary sinus.
OBJECTIVE
The purpose of this study was to analyze the velocities across the coronary sinus ostium (cross-CSo) and within the coronary sinus (intra-CS) in patients with and without paroxysmal atrial (AF) fibrillation and to estimate the interatrial conduction deterioration area in AF patients.


BACKGROUND
Interatrial conduction delay in AF patients has been reported. However, localization of the interatrial conduction delay still is not clear.


METHODS
Thirteen patients with paroxysmal AF and 10 control patients with AV nodal reentrant tachycardia or ectopic atrial tachycardia were enrolled in the study. Right atrial and CS mapping were performed using the CARTO electroanatomic mapping system during sinus rhythm and during distal CS pacing. The activation times and spatial distances of cross-CSo and intra-CS were measured between paired sites, from which the activation velocities of cross-CSo and intra-CS were obtained.


RESULTS
During sinus rhythm, the activation velocities of cross-CSo in the AF group (1.2 +/- 0.2 m/s) were significantly slower than those in the control group (2.9 +/- 1.6 m/s, P < .05). During distal CS pacing, the cross-CSo velocities of the AF group (1.0 +/- 0.5 m/s) also appeared slower than those in the control group (1.4 +/- 0.2 m/s, P = .07). However, no difference was found in intra-CS activation velocities between the two groups (2.8 +/- 1.9 vs 3.2 +/- 2.2 m/s and 1.5 +/- 0.3 vs 1.4 +/- 0.3 m/s, P > .05 during sinus rhythm and distal CS pacing, respectively).


CONCLUSIONS
Interatrial conduction at the posteroparaseptal region across the CS ostium was significantly slower in patients with paroxysmal AF than in control patients, further supporting the link between interatrial conduction deterioration and paroxysmal AF.
Xia
Yunlong
Y
Department of Cardiology, University Hospital, Lund, Sweden.
Hertervig
Eva
E
Kongstad
Ole
O
Ljungström
Erik
E
Platonov
Pyotr
P
Pyotr
Platonov
P
Holm
Magnus
M
Olsson
Bertil
B
Yuan
Shiwen
S
D001281:Atrial Fibrillation / Q000503:physiopathology*; D016275:Atrial Function / Q000502:physiology*; D016022:Case-Control Studies; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D013617:Tachycardia, Supraventricular / Q000503:physiopathology