Intra-Atrial Pressure Increases Rate and Organization of Waves Emanating From the Superior Pulmonary Veins During Atrial Fibrillation
- 12 August 2003
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 108 (6), 668-671
- https://doi.org/10.1161/01.cir.0000086979.39843.7b
Abstract
Background— Atrial fibrillation (AF) commonly associates with atrial dilatation by poorly understood mechanisms. We hypothesized that elevation of intra-atrial pressure elicits high-frequency and spatio-temporally organized left atrial (LA) sources emanating from the superior pulmonary veins. Methods and Results— We used a stretch-related AF model in the sheep heart to induce stable episodes of AF (>40 minutes) in 9 animals. Video movies of the LA free wall (LAFW) and LA superior pulmonary vein junction (JPV) were obtained by using di-4-ANEPPS. Electrograms from the right atrium were recorded. At intra-atrial pressures >10 cm H 2 O, the maximum dominant frequency (DF Max ) was significantly higher in the JPV than in the LAFW (12.0±0.2 and 10.5±0.2 Hz, respectively [mean±SEM]; P 2 O, DF Max was similar in the JPV and LAFW (10.8±0.3 versus 10.2±0.3 Hz; P =0.6); DF Max in both JPV and LAFW was significantly higher than in the right atrium (7.8±0.3 Hz; P r =0.79, P =0.02) but not from the LAFW ( r =0.54, P =0.09). The number of spatio-temporally periodic waves in the JPV correlated with pressure ( r =0.92, P =0.002). In 3 cases, JPV rotors were identified with a cycle length equal to 1/DF Max . Conclusion— We demonstrate for the first time that an increase in intra-atrial pressure increases the rate and organization of waves emanating from the superior pulmonary veins underlying stretch-related AF.Keywords
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