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Europace 2001 3(2):100-107; doi:10.1053/eupc.2001.0150
© 2001 by European Society of Cardiology
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REGULAR ARTICLES

Further evidence of localized posterior interatrial conduction delay in lone paroxysmal atrial fibrillation

P. G. Platonov1, S. Yuan2, E. Hertervig2, O. Kongstad2, A. Roijer2, A. B. Vygovsky1, L. V. Chireikin1 and S. B. Olsson2

1Arrhythmia Research Laboratory, Research Institute of Cardiology St Petersburg, Russia; 2Department of Cardiology, Lund University Sweden

AIMS: Prolongation of interatrial conduction time has been reported in patients with paroxysmal atrial fibrillation (PAF). The study objective was to localize the region of the conduction delay in patients with lone PAF.

METHODS AND RESULTS: Twenty-one patients with lone PAF and 23 patients with AV nodal re-entrant tachycardia ablation without history of PAF (control group) were recruited. Endocardial recordings were made during sinus rhythm and programmed atrial stimulation. The authors measured the interatrial conduction time, the ‘right-sided’ conduction time between the high lateral right atrium and the proximal coronary sinus (RA-CSp), and the ‘left-sided’ conduction time between the proximal and the distal coronary sinus (CSp-LA). During sinus rhythm, the interatrial conduction time was longer in the PAF group (103±19 vs 86±12 ms, P<0·01) due to delay of right-sided conduction (RA-CSp was 74±20 vs 56±10 ms, P<0·01). During programmed stimulation at the distal coronary sinus, the maximal RA-CSp time was also longer in the PAF group (110±47 vs 69±16 ms,P<0·05). No differences in CSp-LA time were observed.

CONCLUSION: This study supports the role of posterior septal right atrial conduction disturbances in the genesis of lone PAF.

Key Words: Lone atrial fibrillation, interatrial conduction, electrophysiology


Correspondence: Pyotr G. Platonov, MD, Department of Cardiology, University Hospital, SE-221 85 Lund, Sweden. E-mail: ppg{at}cpr.spb.ru


[1] Haïssaguerre M, Jais P, Shah DC, et al. Right and left atrial radiofrequency catheter therapy of paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 1996; 7: 1132–1144.[Web of Science][Medline]

[2] Haïssaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998; 339: 659–666.[Abstract/Free Full Text]

[3] Waktare JEP, Hnatkova K, Sopher SM, Murgatroyd FD, Camm AJ, Malik M. Is paroxysmal atrial fibrillation initiated by an atrial focus? — Holter evidence. J Am Coll Cardiol 1998; 31: 368A.

[4] Hnatkova K, Waktare JEP, Murgatroyd FD, Guo X, Camm AJ, Malik M. Alternating short cycles before the onset of paroxysmal atrial fibrillation. J Am Coll Cardiol 1998; 31: 432A (Abstract).

[5] Jais P, Haïssaguerre M, Shah DC, et al. A focal source of atrial fibrillation treated by discrete radiofrequency ablation. Circulation 1997; 95: 572–576.[Abstract/Free Full Text]

[6] Cosio FG, Palacios J, Vidal JM, Cocina EG, Gomez-Sanchez MA, Tamargo L. Electrophysiologic studies in atrial fibrillation. Slow conduction of premature impulses: a possible manifestation of the background for reentry. Am J Cardiol 1983; 51: 122–130.[CrossRef][Web of Science][Medline]

[7] Shimizu A, Fukatani M, Tanigawa M, Mori M, Hashiba K. Intra-atrial conduction delay and fragmented atrial activity in patients with paroxysmal atrial fibrillation. Jpn Circ J 1989; 53: 1023–1030.[Medline]

[8] Prakash A, Saksena S, Hill M, et al. Acute effects of dual-site right atrial pacing in patients with spontaneous and inducible atrial flutter and fibrillation. J Am Coll Cardiol 1997; 29: 1007–1014.[Abstract]

[9] Daubert C, Mabo P, Berder V, De Place C, Paillard F, Druelles V. Arrhythmia prevention by permanent atrial resynchronization in patients with advanced interatrial block. Eur Heart J 1990; 11: 237 (Abstract).

[10] Padeletti L, Porciani MC, Michelucci A, et al. Interatrial septum pacing: a new approach to prevent paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 1998; 21: 797 (Abstract).

[11] Yu WC, Chen SA, Tai CT, Tsai CF, Ding YA, Chang MS. Is biatrial pacing the best mode in prevention of atrial fibrillation? Pacing Clin Electrophysiol 1998; 21: 863 (Abstract).

[12] Platonov P, Carlson J, Ingemansson M, et al. Detection of inter-atrial conduction defects with unfiltered signal-averaged P-wave ECG in patients with lone atrial fibrillation. Europace 2000; 2: 32–41.[Abstract/Free Full Text]

[13] Ndrepepa G, Caref EB, Yin H, el Sherif N, Restivo M. Activation time determination by high-resolution unipolar and bipolar extracellular electrograms in the canine heart. J Cardiovasc Electrophysiol 1995; 6: 174–188.[Web of Science][Medline]

[14] Roithinger F, Cheng J, SippensGroenewegen A, et al. Use of electroanatomic mapping to delineate transseptal atrial conduction in humans. Circulation 1999; 100: 1791–1797.[Abstract/Free Full Text]

[15] Shah D, Haïssaguerre M, Jais P, Takahashi A, Hocini M, Clementy J. Dual input right to left atrial activation correlating with P wave morphology. Pacing Clin Electrophysiol 1999; 22: 832.

[16] Antz M, Otomo K, Arruda M, et al. Electrical conduction between the right atrium and the left atrium via the musculature of the coronary sinus. Circulation 1998; 98: 1790–1795.[Abstract/Free Full Text]

[17] Hashiba K, Centurion OA, Shimizu A. Electrophysiologic characteristics of human atrial muscle in paroxysmal atrial fibrillation. Am Heart J 1996; 131: 778–789.[CrossRef][Web of Science][Medline]

[18] Harada A, Sasaki K, Fukushima T, et al. Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease. Ann Thorac Surg 1996; 61: 104–111.[Abstract/Free Full Text]

[19] Haïssaguerre M, Shah DC, Jais P, Clementy J. Role of catheter ablation for atrial fibrillation. Curr Opin Cardiol 1997; 12: 18–23.[Web of Science][Medline]

[20] Omori I, Inoue D, Shirayama T, Asayama J, Katsume H, Nakagawa M. Prolonged atrial activity due to delayed conduction in the atrium of patients with paroxysmal atrial fibrillation. Heart Vessels 1991; 6: 224–228.[CrossRef][Medline]

[21] Lee YS and Lien WP. His bundle electrogram in rheumatic mitral valve disease with special reference to Bachmann's bundle block in P mitrale. Jpn Circ J 1975; 39: 935–945.[Medline]

[22] Konoe A, Fukatani M, Tanigawa M, et al. Electrophysiological abnormalities of the atrial muscle in patients with manifest Wolff-Parkinson-White syndrome associated with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 1992; 15: 1040–1052.[CrossRef][Medline]

[23] Hashiba K, Tanigawa M, Fukatani M, et al. Electrophysiologic properties of atrial muscle in paroxysmal atrial fibrillation. Am J Cardiol 1989; 64: 20J–23J.[CrossRef][Medline]

[24] Capucci A, Biffi M, Boriani G, et al. Dynamic electrophysiological behavior of human atria during paroxysmal atrial fibrillation. Circulation 1995; 92: 1193–1202.[Abstract/Free Full Text]

[25] Kumagai K, Akimitsu S, Kawahira K, et al. Electrophysiological properties in chronic lone atrial fibrillation. Circulation 1991; 84: 1662–1668.[Abstract/Free Full Text]

[26] Davidson E, Rotenberg Z, Weinberger I, Fuchs J, Agmon J. Diagnosis and characteristics of lone atrial fibrillation. Chest 1989; 95: 1048–1050.[Abstract/Free Full Text]

[27] Centurion OA, Isomoto S, Shimizu A, et al. Supernormal atrial conduction and its relation to atrial vulnerability and atrial fibrillation in patients with sick sinus syndrome and paroxysmal atrial fibrillation. Am Heart J 1994; 128: 88–95.[CrossRef][Web of Science][Medline]

[28] Simpson RJ Jr, Foster JR, Mulrow JP, Gettes LS. The electrophysiological substrate of atrial fibrillation. Pacing Clin Electrophysiol 1983; 6: 1166–1170.[CrossRef][Medline]

[29] Josephson ME. Electrophysiologic investigation: general concepts. Clinical Cardiac Electrophysiology: Techniques and Interpretations 1993; Philadelphia/London Lea & Febiger pp. 22–70.

[30] Papageorgiou P, Monahan K, Boyle NG, et al. Site-dependent intra-atrial conduction delay. Relationship to initiation of atrial fibrillation. Circulation 1996; 94: 384–389.[Abstract/Free Full Text]

[31] Papageorgiou P, Anselme F, Kirchhof CJ, et al. Coronary sinus pacing prevents induction of atrial fibrillation. Circulation 1997; 96: 1893–1898.[Abstract/Free Full Text]

[32] Saksena S, Giorgberidze I, Prakash A, et al. Endocardial mapping during induced atrial fibrillation. Circulation 1996; 94: 3249.

[33] Jais P, Haïssaguerre M, Shah DC, Chouairi S, Clementy J. Regional disparities of endocardial atrial activation in paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 1996; 19: 1998–2003.[CrossRef][Medline]

[34] Lewalter T, Schumacher B, Jung W, Luderitz B. Atrial conduction characteristics in patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 1998; 21: 865 (Abstract).

[35] Yu W-C, Chen S-A, Tai C-T, et al. Effects of different atrial pacing modes on atrial electrophysiology. Circulation 1997; 96: 2992–2996.[Medline]


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