title: Impairment of the atrial substrates by chronic cigarette smoking in patients with atrial fibrillation.
abstract: 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.
authors.affiliation: School of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Tai
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Wanwarang
authors.initials: W
authors.lastname: Wongcharoen
authors.forename: Ameya R
authors.initials: AR
authors.lastname: Udyavar
authors.forename: Shuo-Ju
authors.initials: SJ
authors.lastname: Chiang
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Kwo-Chang
authors.initials: KC
authors.lastname: Ueng
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: 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*