期刊
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY
卷 5, 期 4, 页码 626-631出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCEP.112.970442
关键词
atrial fibrillation; electrophysiology; hypertension; pacemakers; remodeling
资金
- St. Jude Medical
- Canadian Institutes of Health Research
Background-In animal models of atrial fibrillation (AF), changes in atrial electrophysiological properties are associated with the development of AF. Their relevance to human AF is unclear. Methods and Results-The Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial enrolled 2580 patients receiving a dual-chamber pacemaker, who were older than the age of 65 and had a history of hypertension, but no history of AF. Serial noninvasive electrophysiological testing was performed over 2 years in a subgroup of 485 patients. There were no differences in the clinical characteristics between patients with and those without device-detected atrial tachyarrhythmias during the first year. Patients with atrial tachyarrhythmias had longer paced (153 +/- 29 versus 145 +/- 28 ms; P=0.046) and sensed (128 +/- 46 versus 118 +/- 25 ms; P=0.06) P-wave durations and were more likely to have AF induced during electrophysiological testing (23.5% versus 13.6%; P=0.03). They had similar corrected sinus node recovery times at 90 bpm (388 +/- 554 versus 376 +/- 466 ms; P=0.86), atrial effective refractory periods at 90 bpm (250 +/- 32 versus 248 +/- 36 ms; P=0.70), and rate-adaptive shortening of the atrial effective refractory periods (14 +/- 13 versus 12 +/- 14 ms; P=0.11). There were no significant differences in the change in electrophysiological properties over 2 years between patients with and those without atrial tachyarrhythmias. Conclusions-Prolonged P-wave duration, but not differences in atrial effective refractory periods, was associated with the development of atrial tachyarrhythmias in pacemaker patients. (Circ Arrhythm Electrophysiol. 2012;5:626-631.)
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