Reversal of atrial electrical remodeling after cardioversion of persistent atrial fibrillation in humans
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作者:
Hobbs, WJC
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Manchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, EnglandManchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, England
Hobbs, WJC
[1
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Fynn, S
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Manchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, EnglandManchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, England
Fynn, S
[1
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Todd, DM
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Manchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, EnglandManchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, England
Todd, DM
[1
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Wolfson, P
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Manchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, EnglandManchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, England
Wolfson, P
[1
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Galloway, M
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Manchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, EnglandManchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, England
Galloway, M
[1
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Garratt, CJ
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Manchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, EnglandManchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, England
Garratt, CJ
[1
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机构:
[1] Manchester Royal Infirm, Manchester Heart Ctr, Manchester M13 9WL, Lancs, England
Background-Although atrial electrical remodeling has been studied extensively in animal models, the reversibility of this phenomenon after termination of clinical atrial fibrillation (AF) has not been demonstrated. We aimed to examine this important question of reversibility by using AF cycle length (AFCL) and coupling intervals of atrial premature beats after cardioversion as measures of atrial refractoriness. Methods and Results We measured AFCL at the right atrial appendage: and distal coronary sinus before attempting internal cardioversion in 39 patients with persistent AF, Patients were monitored by daily transtelephonic recordings after discharge and admitted rapidly for repeat internal cardioversion if there was spontaneous AF recurrence. Measurements of AFCL were repeated immediately before repeat cardioversions in the 17 patients who had recurrence of AF, There was an increase in AFCL from the initial cardioversion to that measured at the time of-first AF recurrence at both the right atrial appendage (161 +/- 22 vs 167 +/- 26 ms, P=0.05) and distal coronary sinus (162 +/- 20 vs; 168 +/- 22 ms, P=0.01) sites. The magnitude of increase in AFCL was positively correlated with duration of sinus rhythm before AF recurrence (r=0.524, P=0.001), Other measures of refractoriness (shortest coupling interval of atrial premature bears and directly measured refractory periods after cardioversion) also increased from initial to subsequent cardioversions, Conclusions-These findings demonstrate that changes in atrial electrophysiology associated with chronic AF in humans are reversible after cardioversion and that the extent of this reversal is dependent on the duration of sinus rhythm after cardioversion.
机构:
Queen Mary Hosp, Div Cardiol, Dept Med, Hong Kong, Hong Kong, Peoples R China
Univ Hong Kong, Res Ctr Heart Brain Hormone & Healthy Aging, Hong Kong, Hong Kong, Peoples R ChinaQueen Mary Hosp, Div Cardiol, Dept Med, Hong Kong, Hong Kong, Peoples R China
Siu, Chung-Wah
Tse, Hung-Fat
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Queen Mary Hosp, Div Cardiol, Dept Med, Hong Kong, Hong Kong, Peoples R China
Univ Hong Kong, Res Ctr Heart Brain Hormone & Healthy Aging, Hong Kong, Hong Kong, Peoples R ChinaQueen Mary Hosp, Div Cardiol, Dept Med, Hong Kong, Hong Kong, Peoples R China
机构:
Univ Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, BelgiumUniv Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, Belgium
De Clercq, D.
Decloedt, A.
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Univ Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, BelgiumUniv Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, Belgium
Decloedt, A.
Sys, S. U.
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Univ Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, BelgiumUniv Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, Belgium
Sys, S. U.
Verheyen, T.
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Univ Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, BelgiumUniv Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, Belgium
Verheyen, T.
Van der Vekens, N.
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Univ Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, BelgiumUniv Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, Belgium
Van der Vekens, N.
van Loon, G.
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Univ Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, BelgiumUniv Ghent, Dept Large Anim Internal Med, Fac Vet Med, B-9820 Merelbeke, Belgium
机构:
Osaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, JapanOsaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, Japan
Takagi, M
Doi, A
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Osaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, JapanOsaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, Japan
Doi, A
Shirai, N
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Osaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, JapanOsaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, Japan
Shirai, N
Hirata, K
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Osaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, JapanOsaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, Japan
Hirata, K
Takemoto, Y
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Osaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, JapanOsaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, Japan
Takemoto, Y
Takeuchi, K
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Osaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, JapanOsaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, Japan
Takeuchi, K
Yoshikawa, J
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Osaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, JapanOsaka City Univ, Grad Sch Med, Dept Internal Med & Cardiol, Abeno Ku, Osaka 5458585, Japan