Functional characterization of atrial electrograms in a pacing-induced heart failure model of atrial fibrillation

Importance of regional atrial connexin40 remodeling

Ming Hsiung Hsieh, Yenn Jiang Lin, Hsueh Hsiao Wang, Li Wei Lo, Shih Lin Chang, Yi Ling Yan, The Ying Chou, Shih Ann Chen, Hung I. Yeh

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Cx40 Remodeling in Atrial Fibrillation Introduction Heart failure (HF) increases the susceptibility to atrial fibrillation (AF) and is associated with altered cardiomyocyte connexin. The regional remodeling of connexin(s) may contribute to the spatiotemporal organization of AF. This study sought to investigate the regional differences in connexin(s) and fibrosis in specific atrial regions and correlate that with the electrogram properties. Methods and Results Biatrial electroanatomic mapping during sinus rhythm (electrogram voltage and velocity) and AF (dominant frequency, DF) was performed in 6 ventricular pacing-induced HF dogs (at 252 beats/minute for 6 weeks) and 6 controls. Atrial tissues were sampled from 7 specific sites for analysis of the connexin and fibrosis. HF caused marked atrial dilatation, and increased the induced AF duration (P <0.001). Remodeled connexins, including a lower expression and more lateralization of both connexin40 (Cx40) and Cx43 as well as increased regional dispersion of Cx40, in the presence of diffuse enhanced atrial fibrosis, characterized the atrial substrate of the HF dogs (P <0.01). Regional analysis showed abnormal velocity and low electrogram voltage in the areas with downregulated Cx40 and Cx43 was enhanced in the presence of marked atrial fibrosis (>30% of area, P <0.01). During AF, lower expression of the Cx40 was associated with higher DF in areas of less and more fibrosis, respectively (R = 0.67 and 0.58, P <0.01). Conclusions An altered expression of connexins correlated with the electrogram properties in the existence of diffuse enhanced atrial fibrosis associated with HF. The regional remodeling of Cx40 is likely an important factor in the maintenance of AF in HF.

Original languageEnglish
Pages (from-to)573-582
Number of pages10
JournalJournal of Cardiovascular Electrophysiology
Volume24
Issue number5
DOIs
Publication statusPublished - May 2013

Fingerprint

Atrial Remodeling
Cardiac Electrophysiologic Techniques
Atrial Fibrillation
Connexins
Heart Failure
Fibrosis
Cardiac Myocytes
Dilatation
Maintenance
Dogs

Keywords

  • atrial fibrillation
  • connexin
  • electrogram
  • fibrosis
  • frequency analysis
  • heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Functional characterization of atrial electrograms in a pacing-induced heart failure model of atrial fibrillation : Importance of regional atrial connexin40 remodeling. / Hsieh, Ming Hsiung; Lin, Yenn Jiang; Wang, Hsueh Hsiao; Lo, Li Wei; Chang, Shih Lin; Yan, Yi Ling; Chou, The Ying; Chen, Shih Ann; Yeh, Hung I.

In: Journal of Cardiovascular Electrophysiology, Vol. 24, No. 5, 05.2013, p. 573-582.

Research output: Contribution to journalArticle

Hsieh, Ming Hsiung ; Lin, Yenn Jiang ; Wang, Hsueh Hsiao ; Lo, Li Wei ; Chang, Shih Lin ; Yan, Yi Ling ; Chou, The Ying ; Chen, Shih Ann ; Yeh, Hung I. / Functional characterization of atrial electrograms in a pacing-induced heart failure model of atrial fibrillation : Importance of regional atrial connexin40 remodeling. In: Journal of Cardiovascular Electrophysiology. 2013 ; Vol. 24, No. 5. pp. 573-582.
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abstract = "Cx40 Remodeling in Atrial Fibrillation Introduction Heart failure (HF) increases the susceptibility to atrial fibrillation (AF) and is associated with altered cardiomyocyte connexin. The regional remodeling of connexin(s) may contribute to the spatiotemporal organization of AF. This study sought to investigate the regional differences in connexin(s) and fibrosis in specific atrial regions and correlate that with the electrogram properties. Methods and Results Biatrial electroanatomic mapping during sinus rhythm (electrogram voltage and velocity) and AF (dominant frequency, DF) was performed in 6 ventricular pacing-induced HF dogs (at 252 beats/minute for 6 weeks) and 6 controls. Atrial tissues were sampled from 7 specific sites for analysis of the connexin and fibrosis. HF caused marked atrial dilatation, and increased the induced AF duration (P <0.001). Remodeled connexins, including a lower expression and more lateralization of both connexin40 (Cx40) and Cx43 as well as increased regional dispersion of Cx40, in the presence of diffuse enhanced atrial fibrosis, characterized the atrial substrate of the HF dogs (P <0.01). Regional analysis showed abnormal velocity and low electrogram voltage in the areas with downregulated Cx40 and Cx43 was enhanced in the presence of marked atrial fibrosis (>30{\%} of area, P <0.01). During AF, lower expression of the Cx40 was associated with higher DF in areas of less and more fibrosis, respectively (R = 0.67 and 0.58, P <0.01). Conclusions An altered expression of connexins correlated with the electrogram properties in the existence of diffuse enhanced atrial fibrosis associated with HF. The regional remodeling of Cx40 is likely an important factor in the maintenance of AF in HF.",
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T1 - Functional characterization of atrial electrograms in a pacing-induced heart failure model of atrial fibrillation

T2 - Importance of regional atrial connexin40 remodeling

AU - Hsieh, Ming Hsiung

AU - Lin, Yenn Jiang

AU - Wang, Hsueh Hsiao

AU - Lo, Li Wei

AU - Chang, Shih Lin

AU - Yan, Yi Ling

AU - Chou, The Ying

AU - Chen, Shih Ann

AU - Yeh, Hung I.

PY - 2013/5

Y1 - 2013/5

N2 - Cx40 Remodeling in Atrial Fibrillation Introduction Heart failure (HF) increases the susceptibility to atrial fibrillation (AF) and is associated with altered cardiomyocyte connexin. The regional remodeling of connexin(s) may contribute to the spatiotemporal organization of AF. This study sought to investigate the regional differences in connexin(s) and fibrosis in specific atrial regions and correlate that with the electrogram properties. Methods and Results Biatrial electroanatomic mapping during sinus rhythm (electrogram voltage and velocity) and AF (dominant frequency, DF) was performed in 6 ventricular pacing-induced HF dogs (at 252 beats/minute for 6 weeks) and 6 controls. Atrial tissues were sampled from 7 specific sites for analysis of the connexin and fibrosis. HF caused marked atrial dilatation, and increased the induced AF duration (P <0.001). Remodeled connexins, including a lower expression and more lateralization of both connexin40 (Cx40) and Cx43 as well as increased regional dispersion of Cx40, in the presence of diffuse enhanced atrial fibrosis, characterized the atrial substrate of the HF dogs (P <0.01). Regional analysis showed abnormal velocity and low electrogram voltage in the areas with downregulated Cx40 and Cx43 was enhanced in the presence of marked atrial fibrosis (>30% of area, P <0.01). During AF, lower expression of the Cx40 was associated with higher DF in areas of less and more fibrosis, respectively (R = 0.67 and 0.58, P <0.01). Conclusions An altered expression of connexins correlated with the electrogram properties in the existence of diffuse enhanced atrial fibrosis associated with HF. The regional remodeling of Cx40 is likely an important factor in the maintenance of AF in HF.

AB - Cx40 Remodeling in Atrial Fibrillation Introduction Heart failure (HF) increases the susceptibility to atrial fibrillation (AF) and is associated with altered cardiomyocyte connexin. The regional remodeling of connexin(s) may contribute to the spatiotemporal organization of AF. This study sought to investigate the regional differences in connexin(s) and fibrosis in specific atrial regions and correlate that with the electrogram properties. Methods and Results Biatrial electroanatomic mapping during sinus rhythm (electrogram voltage and velocity) and AF (dominant frequency, DF) was performed in 6 ventricular pacing-induced HF dogs (at 252 beats/minute for 6 weeks) and 6 controls. Atrial tissues were sampled from 7 specific sites for analysis of the connexin and fibrosis. HF caused marked atrial dilatation, and increased the induced AF duration (P <0.001). Remodeled connexins, including a lower expression and more lateralization of both connexin40 (Cx40) and Cx43 as well as increased regional dispersion of Cx40, in the presence of diffuse enhanced atrial fibrosis, characterized the atrial substrate of the HF dogs (P <0.01). Regional analysis showed abnormal velocity and low electrogram voltage in the areas with downregulated Cx40 and Cx43 was enhanced in the presence of marked atrial fibrosis (>30% of area, P <0.01). During AF, lower expression of the Cx40 was associated with higher DF in areas of less and more fibrosis, respectively (R = 0.67 and 0.58, P <0.01). Conclusions An altered expression of connexins correlated with the electrogram properties in the existence of diffuse enhanced atrial fibrosis associated with HF. The regional remodeling of Cx40 is likely an important factor in the maintenance of AF in HF.

KW - atrial fibrillation

KW - connexin

KW - electrogram

KW - fibrosis

KW - frequency analysis

KW - heart failure

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