Impact of atrial programmed electrical stimulation techniques on unipolar electrogram morphology.
Action Potentials
Adolescent
Adult
Aged
Aged, 80 and over
Atrial Fibrillation
/ diagnosis
Atrial Function
Cardiac Pacing, Artificial
Case-Control Studies
Child
Databases, Factual
Electrophysiologic Techniques, Cardiac
Female
Heart Rate
Humans
Male
Middle Aged
Predictive Value of Tests
Refractory Period, Electrophysiological
Time Factors
Young Adult
atrial fibrillation
atrial programmed electrical stimulation
conduction abnormalities
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
05
11
2019
revised:
28
01
2020
accepted:
10
02
2020
pubmed:
15
2
2020
medline:
3
2
2021
entrez:
15
2
2020
Statut:
ppublish
Résumé
Intra-atrial conduction abnormalities are associated with the development of atrial fibrillation (AF) and cause morphological changes of the unipolar atrial electrogram (U-AEGM). This study examined the impact of different atrial programmed electrical stimulation (APES) protocols on U-AEGM morphology to identify the most optimal APES protocol provoking conduction abnormalities. APES techniques (14 protocols) were applied in 30 patients referred for an electrophysiology study, consisting of fixed rate, extra, and decremental stimuli at different frequencies. U-AEGM morphologies including width, amplitude, and fractionation for patients without (control group) and with a history of AF (AF group) were examined during APES. In addition, sinus rhythm (SR) U-AEGMs preceding different APES protocols were compared to evaluate the morphology stability over time. U-AEGM morphologies during SR before the APES protocols were comparable (all P > .396). Atrial refractoriness was longer in the AF group compared to the control group (298 ± 48 vs 255 ± 33 ms; P ≤ .020), but did not differ between AF patients with and without amiodarone therapy (278 ± 48 vs 311 ± 40 ms; P ≥ .126). Compared to the initial SR morphology, U-AEGM width, amplitude, and fractionation changed significantly during the 14 different APES protocols, particularly in the AF group. In both groups, U-AEGM changes in morphology were most pronounced during fixed-rate stimulation with extra stimuli (8S1-S2 = 400-250 ms). APES results in significant changes in U-AEGM morphology, including width, amplitude, and fractionation. The impact of APES differed between APES sequence and between patients with and without AF. These findings suggest that APES could be useful to identify AF-related conduction abnormalities in the individual patient.
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
943-951Informations de copyright
© 2020 Wiley Periodicals, Inc.
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