Impairment of the atrial substrates by chronic cigarette smoking in patients with atrial fibrillation.
BACKGROUND
Smoking is a major risk factor for cardiovascular disease. The impact of smoking on the right and left atrial substrates is unknown.


METHODS
This study included 88 patients (age 50 +/- 13 years, M/F = 71/17) who underwent four pulmonary veins isolation (PVI) for paroxysmal atrial fibrillation (AF). The mean voltage and total activation time of the individual atria were obtained by using a NavX mapping system, and were compared between the patients with and without a previous smoking history. The dose effect was evaluated by the smoking intensity-duration, defined as the number of packs per day plus how many years they had been smoking.


RESULTS
The right atrial (RA) mean voltage was lower in the patients with a previous history of smoking than in those without a history of smoking (1.92 +/- 0.49 vs 2.17 +/- 0.56 mV, P < 0.05). The left atrial (LA) mean voltage was similar between the two groups (1.73 +/- 0.67 vs 1.82 +/- 0.48 mV, P = 0.488). Further, the total activation time of the RA was longer in the patients with a previous history of smoking than in those without a history of smoking, but not so for the LA. Furthermore, the voltage reduction in the RA was related to the smoking intensity-duration (Pearson's correlation, r = 0.650, P < 0.001).


CONCLUSIONS
In patients with atrial fibrillation, the RA mean voltage and total activation time were significantly correlated to smoking and had a dose-dependent effect.
Tuan
Ta-Chuan
TC
School of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Chang
Shih-Lin
SL
Tai
Ching-Tai
CT
Lin
Yenn-Jiang
YJ
Hu
Yu-Feng
YF
Lo
Li-Wei
LW
Wongcharoen
Wanwarang
W
Udyavar
Ameya R
AR
Chiang
Shuo-Ju
SJ
Chen
Yi-Jen
YJ
Tsao
Hsuan-Ming
HM
Ueng
Kwo-Chang
KC
Chen
Shih-Ann
SA
D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000209:etiology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*