Effect of phenylephrine on focal atrial fibrillation originating in the pulmonary veins and superior vena cava

Ching Tai Tai, Chuen Wang Chiou, Zu Chi Wen, Ming Hsiung Hsieh, Chin Feng Tsai, Wei Shiang Lin, Chien Cheng Chen, Yung Kuo Lin, Wen Chung Yu, Yu An Ding, Mau Song Chang, Shin Ann Chen

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Abstract

OBJECTIVES: This study was aimed at evaluating the effects of phenylephrine infusion on the occurrence of focal atrial fibrillation (AF). BACKGROUND: Paroxysmal AF can be initiated by ectopic atrial beats originating in the pulmonary vein (PV) or superior vena cava (SVC). The effect of change in autonomic tone on this focal AF is unknown. METHODS: This study included 12 patients with frequent bursts of AF documented by 24-h Holter monitoring. The number and coupling interval of spontaneous ectopic activity and bursts of AF were evaluated for 1 min before and after phenylephrine (2 to 3 μg/kg) injection. RESULTS: After detailed mapping, four patients had a focus located in the left superior PV, six in the right superior PV and two in the SVC. In 10 patients with AF foci originating in the PVs, the frequency of ectopic activity (19.5 ± 27.4 vs. 11.4 ± 22.9 beats/min, p = 0.059) was reduced as well as AF bursts (14 ± 3 vs. 1.8 ± 2.7 bursts/min, p = 0.005) before versus after phenylephrine injection; the minimal coupling interval of ectopic activity and AF bursts became longer compared with baseline. The maximal percent increase in sinus cycle length after phenylephrine injection was significantly greater in patients with complete suppression of AF compared with those with partial suppression (43 ± 19 vs. 14 ± 5%, p = 0.01). However, no significant effect of phenylephrine on AF originating in the SVC was found. CONCLUSIONS: Change in autonomic tone induced by phenylephrine injection was effective in suppressing focal AF originating in the PVs but not in the SVC. (C) 2000 by the American College of Cardiology.

Original languageEnglish
Pages (from-to)788-793
Number of pages6
JournalJournal of the American College of Cardiology
Volume36
Issue number3
DOIs
Publication statusPublished - 2000
Externally publishedYes

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Superior Vena Cava
Pulmonary Veins
Phenylephrine
Atrial Fibrillation
Injections
Atrial Premature Complexes
Ambulatory Electrocardiography

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Effect of phenylephrine on focal atrial fibrillation originating in the pulmonary veins and superior vena cava. / Tai, Ching Tai; Chiou, Chuen Wang; Wen, Zu Chi; Hsieh, Ming Hsiung; Tsai, Chin Feng; Lin, Wei Shiang; Chen, Chien Cheng; Lin, Yung Kuo; Yu, Wen Chung; Ding, Yu An; Chang, Mau Song; Chen, Shin Ann.

In: Journal of the American College of Cardiology, Vol. 36, No. 3, 2000, p. 788-793.

Research output: Contribution to journalArticle

Tai, Ching Tai ; Chiou, Chuen Wang ; Wen, Zu Chi ; Hsieh, Ming Hsiung ; Tsai, Chin Feng ; Lin, Wei Shiang ; Chen, Chien Cheng ; Lin, Yung Kuo ; Yu, Wen Chung ; Ding, Yu An ; Chang, Mau Song ; Chen, Shin Ann. / Effect of phenylephrine on focal atrial fibrillation originating in the pulmonary veins and superior vena cava. In: Journal of the American College of Cardiology. 2000 ; Vol. 36, No. 3. pp. 788-793.
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abstract = "OBJECTIVES: This study was aimed at evaluating the effects of phenylephrine infusion on the occurrence of focal atrial fibrillation (AF). BACKGROUND: Paroxysmal AF can be initiated by ectopic atrial beats originating in the pulmonary vein (PV) or superior vena cava (SVC). The effect of change in autonomic tone on this focal AF is unknown. METHODS: This study included 12 patients with frequent bursts of AF documented by 24-h Holter monitoring. The number and coupling interval of spontaneous ectopic activity and bursts of AF were evaluated for 1 min before and after phenylephrine (2 to 3 μg/kg) injection. RESULTS: After detailed mapping, four patients had a focus located in the left superior PV, six in the right superior PV and two in the SVC. In 10 patients with AF foci originating in the PVs, the frequency of ectopic activity (19.5 ± 27.4 vs. 11.4 ± 22.9 beats/min, p = 0.059) was reduced as well as AF bursts (14 ± 3 vs. 1.8 ± 2.7 bursts/min, p = 0.005) before versus after phenylephrine injection; the minimal coupling interval of ectopic activity and AF bursts became longer compared with baseline. The maximal percent increase in sinus cycle length after phenylephrine injection was significantly greater in patients with complete suppression of AF compared with those with partial suppression (43 ± 19 vs. 14 ± 5{\%}, p = 0.01). However, no significant effect of phenylephrine on AF originating in the SVC was found. CONCLUSIONS: Change in autonomic tone induced by phenylephrine injection was effective in suppressing focal AF originating in the PVs but not in the SVC. (C) 2000 by the American College of Cardiology.",
author = "Tai, {Ching Tai} and Chiou, {Chuen Wang} and Wen, {Zu Chi} and Hsieh, {Ming Hsiung} and Tsai, {Chin Feng} and Lin, {Wei Shiang} and Chen, {Chien Cheng} and Lin, {Yung Kuo} and Yu, {Wen Chung} and Ding, {Yu An} and Chang, {Mau Song} and Chen, {Shin Ann}",
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TY - JOUR

T1 - Effect of phenylephrine on focal atrial fibrillation originating in the pulmonary veins and superior vena cava

AU - Tai, Ching Tai

AU - Chiou, Chuen Wang

AU - Wen, Zu Chi

AU - Hsieh, Ming Hsiung

AU - Tsai, Chin Feng

AU - Lin, Wei Shiang

AU - Chen, Chien Cheng

AU - Lin, Yung Kuo

AU - Yu, Wen Chung

AU - Ding, Yu An

AU - Chang, Mau Song

AU - Chen, Shin Ann

PY - 2000

Y1 - 2000

N2 - OBJECTIVES: This study was aimed at evaluating the effects of phenylephrine infusion on the occurrence of focal atrial fibrillation (AF). BACKGROUND: Paroxysmal AF can be initiated by ectopic atrial beats originating in the pulmonary vein (PV) or superior vena cava (SVC). The effect of change in autonomic tone on this focal AF is unknown. METHODS: This study included 12 patients with frequent bursts of AF documented by 24-h Holter monitoring. The number and coupling interval of spontaneous ectopic activity and bursts of AF were evaluated for 1 min before and after phenylephrine (2 to 3 μg/kg) injection. RESULTS: After detailed mapping, four patients had a focus located in the left superior PV, six in the right superior PV and two in the SVC. In 10 patients with AF foci originating in the PVs, the frequency of ectopic activity (19.5 ± 27.4 vs. 11.4 ± 22.9 beats/min, p = 0.059) was reduced as well as AF bursts (14 ± 3 vs. 1.8 ± 2.7 bursts/min, p = 0.005) before versus after phenylephrine injection; the minimal coupling interval of ectopic activity and AF bursts became longer compared with baseline. The maximal percent increase in sinus cycle length after phenylephrine injection was significantly greater in patients with complete suppression of AF compared with those with partial suppression (43 ± 19 vs. 14 ± 5%, p = 0.01). However, no significant effect of phenylephrine on AF originating in the SVC was found. CONCLUSIONS: Change in autonomic tone induced by phenylephrine injection was effective in suppressing focal AF originating in the PVs but not in the SVC. (C) 2000 by the American College of Cardiology.

AB - OBJECTIVES: This study was aimed at evaluating the effects of phenylephrine infusion on the occurrence of focal atrial fibrillation (AF). BACKGROUND: Paroxysmal AF can be initiated by ectopic atrial beats originating in the pulmonary vein (PV) or superior vena cava (SVC). The effect of change in autonomic tone on this focal AF is unknown. METHODS: This study included 12 patients with frequent bursts of AF documented by 24-h Holter monitoring. The number and coupling interval of spontaneous ectopic activity and bursts of AF were evaluated for 1 min before and after phenylephrine (2 to 3 μg/kg) injection. RESULTS: After detailed mapping, four patients had a focus located in the left superior PV, six in the right superior PV and two in the SVC. In 10 patients with AF foci originating in the PVs, the frequency of ectopic activity (19.5 ± 27.4 vs. 11.4 ± 22.9 beats/min, p = 0.059) was reduced as well as AF bursts (14 ± 3 vs. 1.8 ± 2.7 bursts/min, p = 0.005) before versus after phenylephrine injection; the minimal coupling interval of ectopic activity and AF bursts became longer compared with baseline. The maximal percent increase in sinus cycle length after phenylephrine injection was significantly greater in patients with complete suppression of AF compared with those with partial suppression (43 ± 19 vs. 14 ± 5%, p = 0.01). However, no significant effect of phenylephrine on AF originating in the SVC was found. CONCLUSIONS: Change in autonomic tone induced by phenylephrine injection was effective in suppressing focal AF originating in the PVs but not in the SVC. (C) 2000 by the American College of Cardiology.

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