Indices of electrical and contractile remodeling during atrial fibrillation in man.
BACKGROUND
Atrial electrical and contractile remodeling have been demonstrated to coincide during atrial fibrillation (AF) in experimental studies. We explored whether electrical and contractile remodeling correlate in man and explored its clinical implications.


METHODS
Forty-nine patients with persistent AF were studied. Electrical remodeling was assessed noninvasively using spectral analysis to estimate the average fibrillatory rate (AFR). Atrial contractility was assessed by transesophageal echocardiography (TEE) measurement of left atrial appendage outflow velocity (LAAOV).


RESULTS
The AFR was 403+/-43 fibrillations per minute (fpm) and the LAAOV was 0.27+/-0.14 m/s. A significant correlation was found between AFR and LAAOV (r=-0.47, P=0.001). In patients with a LAAOV>or=0.25 m/s, the AFR was 387+/-48 fpm compared to 419+/-31 fpm among patients with LAAOV<0.25 m/s (P<0.01).


CONCLUSIONS
This study demonstrates that indices of electrical and contractile remodeling are strongly correlated in persistent AF in man. The interindividual overlap, however, is too large to allow predictions of LAAOV based on fibrillatory frequency alone.
Holmqvist
Fredrik
F
Department of Cardiology, Lund University Hospital, Lund, Sweden. Frederik.Holmqvist@kard.lu.se
Stridh
Martin
M
Waktare
Johan E P
JE
Sörnmo
Leif
L
Roijer
Anders
A
Meurling
Carl J
CJ
D000200:Action Potentials; D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006305:Health Status Indicators; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009200:Myocardial Contraction; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology*