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Electrophysiological Changes of the Atrium in Patients with Lone Paroxysmal Atrial Fibrillation

Introduction: Paroxysmal atrial fibrillation (PAF) is a common arrhythmia, and it is associated with various cardiac conditions. On the other hand, lone PAF has no identifiable underlying cause, and can occur any time for no apparent reason. The underlying causes may modify the electrophysiological properties of the atrium in different ways and extent. However this setting may be different in patients with lone PAF. We sought to investigate the atrial electrophysiological properties in lone PAF.
Material and Methods: This study included 62 control subjects (Control group) and 58 patients with lone PAF (LAF group). The following atrial vulnerability parameters induced by programmed atrial stimulation were assessed and quantitatively measured: 1) the atrial effective refractory period (ERP), 2) the atrial conduction delay (CD) zone, and 3) the maximum CD.
Results: The mean atrial ERP of the Control group was 21529 ms, and that of LAF group was 20828 ms, p<0.05. The mean atrial CD zone of the LAF group was (5028 ms) significantly greater than that of controls (3422 ms) (p<0.01). The mean maximum CD of the LAF group (6229 ms) was also significantly greater than that of controls (4320 ms) (p<0.01).
Conclusions: There is a greater conduction delay of the atrium and shorter refractoriness in patients with lone PAF. Patients without underlying causes for the development of PAF exhibit abnormalities in the electrophysiological properties of the atrium.
Key words: Atrial vulnerability. Atrial refractory period. Atrial conduction time. Atrial fibrillation. Atrial conduction delay.

Credits: Osmar Antonio Centurion, MD, PhD, FACC; Shojiro Isomoto, MD, PhD; Akihiko Shimizu, MD, PhD, FACC

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