Inducibility of atrial fibrillation during atrioventricular pacing with varying intervals: Role of atrial electrophysiology and the autonomic nervous system

Yi Jen Chen, Ching Tai Tai, Chuen Wang Chiou, Zu Chin Wen, Paul Chan, Shih Huang Lee, Shih Ann Chen

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Introduction: Patients receiving VVI pacemakers have a higher incidence of paroxysmal atrial fibrillation (AF) than those receiving DDD pacemakers. However, the mechanism behind the difference is not clear. The purpose of this study was to investigate whether atrial electrophysiology and the autonomic nervous system play a role in the occurrence of AF during AV pacing. Methods and Results: The study population consisted of 28 patients who had (group I, n = 15) or did not have (group II, n = 13) AF induced by a single extrastimulus during pacing with different AV intervals. Atrial pressure, atrial size, atrial effective refractory periods, and atrial dispersion were evaluated during pacing with different AV intervals. Twenty- four-hour heart rate variability and baroreflex sensitivity also were examined. Atrial pressure, atrial size, effective refractory periods in the right posterolateral atrium and distal coronary sinus, and atrial dispersion increased as the AV interval shortened from 160 to 0 msec. During AV pacing, group I patients had greater minimal (52 ± 17 vs 25 ± 7 msec; P <0.005) and maximal (76 ± 16 vs 36 ± 9 msec; P <0.005) atrial dispersion than group II patients. The differences in atrial size and atrial dispersion among different AV intervals were greater in patients with AF than in those without AF. Baroreflex sensitivity (6.6 ± 1.7 vs 3.9 ± 1.0; P <0.00005), but not heart rate variability, was higher in patients with AF than in those without AF. Conclusion: Abnormal atrial electrophysiology and higher vagal reflex activity can play important roles in the genesis of AF in patients receiving pacemakers.

Original languageEnglish
Pages (from-to)1578-1585
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume10
Issue number12
Publication statusPublished - 1999
Externally publishedYes

Fingerprint

Electrophysiology
Autonomic Nervous System
Atrial Fibrillation
Atrial Pressure
Baroreflex
Heart Rate
Dichlorodiphenyldichloroethane
Coronary Sinus
Heart Atria
Reflex
Incidence
Population

Keywords

  • Atrial fibrillation
  • Atrioventricular pacing
  • Autonomic nervous system

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Inducibility of atrial fibrillation during atrioventricular pacing with varying intervals : Role of atrial electrophysiology and the autonomic nervous system. / Chen, Yi Jen; Tai, Ching Tai; Chiou, Chuen Wang; Wen, Zu Chin; Chan, Paul; Lee, Shih Huang; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 10, No. 12, 1999, p. 1578-1585.

Research output: Contribution to journalArticle

@article{9d89fe2061674131ad4e29a404b77cff,
title = "Inducibility of atrial fibrillation during atrioventricular pacing with varying intervals: Role of atrial electrophysiology and the autonomic nervous system",
abstract = "Introduction: Patients receiving VVI pacemakers have a higher incidence of paroxysmal atrial fibrillation (AF) than those receiving DDD pacemakers. However, the mechanism behind the difference is not clear. The purpose of this study was to investigate whether atrial electrophysiology and the autonomic nervous system play a role in the occurrence of AF during AV pacing. Methods and Results: The study population consisted of 28 patients who had (group I, n = 15) or did not have (group II, n = 13) AF induced by a single extrastimulus during pacing with different AV intervals. Atrial pressure, atrial size, atrial effective refractory periods, and atrial dispersion were evaluated during pacing with different AV intervals. Twenty- four-hour heart rate variability and baroreflex sensitivity also were examined. Atrial pressure, atrial size, effective refractory periods in the right posterolateral atrium and distal coronary sinus, and atrial dispersion increased as the AV interval shortened from 160 to 0 msec. During AV pacing, group I patients had greater minimal (52 ± 17 vs 25 ± 7 msec; P <0.005) and maximal (76 ± 16 vs 36 ± 9 msec; P <0.005) atrial dispersion than group II patients. The differences in atrial size and atrial dispersion among different AV intervals were greater in patients with AF than in those without AF. Baroreflex sensitivity (6.6 ± 1.7 vs 3.9 ± 1.0; P <0.00005), but not heart rate variability, was higher in patients with AF than in those without AF. Conclusion: Abnormal atrial electrophysiology and higher vagal reflex activity can play important roles in the genesis of AF in patients receiving pacemakers.",
keywords = "Atrial fibrillation, Atrioventricular pacing, Autonomic nervous system",
author = "Chen, {Yi Jen} and Tai, {Ching Tai} and Chiou, {Chuen Wang} and Wen, {Zu Chin} and Paul Chan and Lee, {Shih Huang} and Chen, {Shih Ann}",
year = "1999",
language = "English",
volume = "10",
pages = "1578--1585",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - Inducibility of atrial fibrillation during atrioventricular pacing with varying intervals

T2 - Role of atrial electrophysiology and the autonomic nervous system

AU - Chen, Yi Jen

AU - Tai, Ching Tai

AU - Chiou, Chuen Wang

AU - Wen, Zu Chin

AU - Chan, Paul

AU - Lee, Shih Huang

AU - Chen, Shih Ann

PY - 1999

Y1 - 1999

N2 - Introduction: Patients receiving VVI pacemakers have a higher incidence of paroxysmal atrial fibrillation (AF) than those receiving DDD pacemakers. However, the mechanism behind the difference is not clear. The purpose of this study was to investigate whether atrial electrophysiology and the autonomic nervous system play a role in the occurrence of AF during AV pacing. Methods and Results: The study population consisted of 28 patients who had (group I, n = 15) or did not have (group II, n = 13) AF induced by a single extrastimulus during pacing with different AV intervals. Atrial pressure, atrial size, atrial effective refractory periods, and atrial dispersion were evaluated during pacing with different AV intervals. Twenty- four-hour heart rate variability and baroreflex sensitivity also were examined. Atrial pressure, atrial size, effective refractory periods in the right posterolateral atrium and distal coronary sinus, and atrial dispersion increased as the AV interval shortened from 160 to 0 msec. During AV pacing, group I patients had greater minimal (52 ± 17 vs 25 ± 7 msec; P <0.005) and maximal (76 ± 16 vs 36 ± 9 msec; P <0.005) atrial dispersion than group II patients. The differences in atrial size and atrial dispersion among different AV intervals were greater in patients with AF than in those without AF. Baroreflex sensitivity (6.6 ± 1.7 vs 3.9 ± 1.0; P <0.00005), but not heart rate variability, was higher in patients with AF than in those without AF. Conclusion: Abnormal atrial electrophysiology and higher vagal reflex activity can play important roles in the genesis of AF in patients receiving pacemakers.

AB - Introduction: Patients receiving VVI pacemakers have a higher incidence of paroxysmal atrial fibrillation (AF) than those receiving DDD pacemakers. However, the mechanism behind the difference is not clear. The purpose of this study was to investigate whether atrial electrophysiology and the autonomic nervous system play a role in the occurrence of AF during AV pacing. Methods and Results: The study population consisted of 28 patients who had (group I, n = 15) or did not have (group II, n = 13) AF induced by a single extrastimulus during pacing with different AV intervals. Atrial pressure, atrial size, atrial effective refractory periods, and atrial dispersion were evaluated during pacing with different AV intervals. Twenty- four-hour heart rate variability and baroreflex sensitivity also were examined. Atrial pressure, atrial size, effective refractory periods in the right posterolateral atrium and distal coronary sinus, and atrial dispersion increased as the AV interval shortened from 160 to 0 msec. During AV pacing, group I patients had greater minimal (52 ± 17 vs 25 ± 7 msec; P <0.005) and maximal (76 ± 16 vs 36 ± 9 msec; P <0.005) atrial dispersion than group II patients. The differences in atrial size and atrial dispersion among different AV intervals were greater in patients with AF than in those without AF. Baroreflex sensitivity (6.6 ± 1.7 vs 3.9 ± 1.0; P <0.00005), but not heart rate variability, was higher in patients with AF than in those without AF. Conclusion: Abnormal atrial electrophysiology and higher vagal reflex activity can play important roles in the genesis of AF in patients receiving pacemakers.

KW - Atrial fibrillation

KW - Atrioventricular pacing

KW - Autonomic nervous system

UR - http://www.scopus.com/inward/record.url?scp=0033385652&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033385652&partnerID=8YFLogxK

M3 - Article

C2 - 10636188

AN - SCOPUS:0033385652

VL - 10

SP - 1578

EP - 1585

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 12

ER -