Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Standard

Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure. / Gottlieb, Lisa A; Vaillant, Fanny; Abell, Emma; Belterman, Charly; Loyer, Virginie; El Hamrani, Dounia; Naulin, Jérôme; Constantin, Marion; Quesson, Bruno; Boukens, Bastiaan J; Coronel, Ruben; Dekker, Lukas R C.

I: Frontiers in Physiology, Bind 12, 709844, 2021.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Harvard

Gottlieb, LA, Vaillant, F, Abell, E, Belterman, C, Loyer, V, El Hamrani, D, Naulin, J, Constantin, M, Quesson, B, Boukens, BJ, Coronel, R & Dekker, LRC 2021, 'Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure', Frontiers in Physiology, bind 12, 709844. https://doi.org/10.3389/fphys.2021.709844

APA

Gottlieb, L. A., Vaillant, F., Abell, E., Belterman, C., Loyer, V., El Hamrani, D., Naulin, J., Constantin, M., Quesson, B., Boukens, B. J., Coronel, R., & Dekker, L. R. C. (2021). Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure. Frontiers in Physiology, 12, [709844]. https://doi.org/10.3389/fphys.2021.709844

Vancouver

Gottlieb LA, Vaillant F, Abell E, Belterman C, Loyer V, El Hamrani D o.a. Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure. Frontiers in Physiology. 2021;12. 709844. https://doi.org/10.3389/fphys.2021.709844

Author

Gottlieb, Lisa A ; Vaillant, Fanny ; Abell, Emma ; Belterman, Charly ; Loyer, Virginie ; El Hamrani, Dounia ; Naulin, Jérôme ; Constantin, Marion ; Quesson, Bruno ; Boukens, Bastiaan J ; Coronel, Ruben ; Dekker, Lukas R C. / Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure. I: Frontiers in Physiology. 2021 ; Bind 12.

Bibtex

@article{dfa2becaf61346bd84bf60ae56fd26a6,

title = "Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure",

abstract = "BACKGROUND: Pulmonary vein (PV) ablation is unsuccessful in atrial fibrillation (AF) patients with high left atrial (LA) pressure. Increased atrial stretch by increased pressure is proarrhythmic for AF, and myocardial scar alters wall deformation. We hypothesized that localized PV scar is proarrhythmic for AF in high LA pressure.METHODS: Radiofrequency energy was delivered locally in the right PV of healthy sheep. The sheep recovered for 4 months. Explanted hearts (n = 9 PV scar, n = 9 controls) were perfused with 1:4 blood:Tyrode's solution in a four-chamber working heart setup. Programmed PV stimulation was performed during low (∼12 mmHg) and high (∼25 mmHg) LA pressure. An AF inducibility index was calculated based on the number of induction attempts and the number of attempts causing AF (run of ≥ 20 premature atrial complexes).RESULTS: In high LA pressure, the presence of PV scar increased the AF inducibility index compared with control hearts (0.83 ± 0.20 vs. 0.38 ± 0.40 arb. unit, respectively, p = 0.014). The diastolic stimulation threshold in high LA pressure was higher (108 ± 23 vs. 77 ± 16 mA, respectively, p = 0.006), and its heterogeneity was increased in hearts with PV scar compared with controls. In high LA pressure, the refractory period was shorter in PV scar than in control hearts (178 ± 39 vs. 235 ± 48 ms, p = 0.011).CONCLUSION: Localized PV scar only in combination with increased LA pressure facilitated the inducibility of AF. This was associated with changes in tissue excitability remote from the PV scar. Localized PV ablation is potentially proarrhythmic in patients with increased LA pressure.",

author = "Gottlieb, {Lisa A} and Fanny Vaillant and Emma Abell and Charly Belterman and Virginie Loyer and {El Hamrani}, Dounia and J{\'e}r{\^o}me Naulin and Marion Constantin and Bruno Quesson and Boukens, {Bastiaan J} and Ruben Coronel and Dekker, {Lukas R C}",

note = "Copyright {\textcopyright} 2021 Gottlieb, Vaillant, Abell, Belterman, Loyer, El Hamrani, Naulin, Constantin, Quesson, Boukens, Coronel and Dekker.",

year = "2021",

doi = "10.3389/fphys.2021.709844",

language = "English",

volume = "12",

journal = "Frontiers in Physiology",

issn = "1664-042X",

publisher = "Frontiers Media S.A.",

}

RIS

TY - JOUR

T1 - Localized Pulmonary Vein Scar Promotes Atrial Fibrillation in High Left Atrial Pressure

AU - Gottlieb, Lisa A

AU - Vaillant, Fanny

AU - Abell, Emma

AU - Belterman, Charly

AU - Loyer, Virginie

AU - El Hamrani, Dounia

AU - Naulin, Jérôme

AU - Constantin, Marion

AU - Quesson, Bruno

AU - Boukens, Bastiaan J

AU - Coronel, Ruben

AU - Dekker, Lukas R C

PY - 2021

Y1 - 2021

N2 - BACKGROUND: Pulmonary vein (PV) ablation is unsuccessful in atrial fibrillation (AF) patients with high left atrial (LA) pressure. Increased atrial stretch by increased pressure is proarrhythmic for AF, and myocardial scar alters wall deformation. We hypothesized that localized PV scar is proarrhythmic for AF in high LA pressure.METHODS: Radiofrequency energy was delivered locally in the right PV of healthy sheep. The sheep recovered for 4 months. Explanted hearts (n = 9 PV scar, n = 9 controls) were perfused with 1:4 blood:Tyrode's solution in a four-chamber working heart setup. Programmed PV stimulation was performed during low (∼12 mmHg) and high (∼25 mmHg) LA pressure. An AF inducibility index was calculated based on the number of induction attempts and the number of attempts causing AF (run of ≥ 20 premature atrial complexes).RESULTS: In high LA pressure, the presence of PV scar increased the AF inducibility index compared with control hearts (0.83 ± 0.20 vs. 0.38 ± 0.40 arb. unit, respectively, p = 0.014). The diastolic stimulation threshold in high LA pressure was higher (108 ± 23 vs. 77 ± 16 mA, respectively, p = 0.006), and its heterogeneity was increased in hearts with PV scar compared with controls. In high LA pressure, the refractory period was shorter in PV scar than in control hearts (178 ± 39 vs. 235 ± 48 ms, p = 0.011).CONCLUSION: Localized PV scar only in combination with increased LA pressure facilitated the inducibility of AF. This was associated with changes in tissue excitability remote from the PV scar. Localized PV ablation is potentially proarrhythmic in patients with increased LA pressure.

AB - BACKGROUND: Pulmonary vein (PV) ablation is unsuccessful in atrial fibrillation (AF) patients with high left atrial (LA) pressure. Increased atrial stretch by increased pressure is proarrhythmic for AF, and myocardial scar alters wall deformation. We hypothesized that localized PV scar is proarrhythmic for AF in high LA pressure.METHODS: Radiofrequency energy was delivered locally in the right PV of healthy sheep. The sheep recovered for 4 months. Explanted hearts (n = 9 PV scar, n = 9 controls) were perfused with 1:4 blood:Tyrode's solution in a four-chamber working heart setup. Programmed PV stimulation was performed during low (∼12 mmHg) and high (∼25 mmHg) LA pressure. An AF inducibility index was calculated based on the number of induction attempts and the number of attempts causing AF (run of ≥ 20 premature atrial complexes).RESULTS: In high LA pressure, the presence of PV scar increased the AF inducibility index compared with control hearts (0.83 ± 0.20 vs. 0.38 ± 0.40 arb. unit, respectively, p = 0.014). The diastolic stimulation threshold in high LA pressure was higher (108 ± 23 vs. 77 ± 16 mA, respectively, p = 0.006), and its heterogeneity was increased in hearts with PV scar compared with controls. In high LA pressure, the refractory period was shorter in PV scar than in control hearts (178 ± 39 vs. 235 ± 48 ms, p = 0.011).CONCLUSION: Localized PV scar only in combination with increased LA pressure facilitated the inducibility of AF. This was associated with changes in tissue excitability remote from the PV scar. Localized PV ablation is potentially proarrhythmic in patients with increased LA pressure.

U2 - 10.3389/fphys.2021.709844

DO - 10.3389/fphys.2021.709844

M3 - Journal article

C2 - 34512384

VL - 12

JO - Frontiers in Physiology

JF - Frontiers in Physiology

SN - 1664-042X

M1 - 709844

ER -

ID: 396850456