Abstract:
BACKGROUND:Arterial hypertension (HT) contributes to progression of atrial fibrillation (AF) via unknown mechanisms. OBJECTIVE:We aimed to characterize electrical and structural changes accounting for increased AF stability in a large animal model of rapid atrial pacing (RAP)-induced AF combined with desoxycorticosterone acetate (DOCA)-induced HT. METHODS:Eighteen pigs were instrumented with right atrial endocardial pacemaker leads and custom-made pacemakers to induce AF by continuous RAP (600 beats/min). DOCA pellets were subcutaneously implanted in a subgroup of 9 animals (AF+HT group); the other 9 animals served as controls (AF group). Final experiments included electrophysiology studies, endocardial electroanatomic mapping, and high-density mapping with epicardial multielectrode arrays. In addition, 3-dimensional computational modeling was performed. RESULTS:DOCA implantation led to secondary HT (median [interquartile range] aortic pressure 109.9 [100-137] mm Hg in AF+HT vs 82.2 [79-96] mm Hg in AF; P < .05), increased AF stability (55.6% vs 12.5% of animals with AF episodes lasting >1 hour; P < .05), concentric left ventricular hypertrophy, atrial dilatation (119 ± 31 cm2 in AF+HT vs 78 ± 23 cm2 in AF; P < .05), and fibrosis. Collagen accumulation in the AF+HT group was mainly found in non-intermyocyte areas (1.62 ± 0.38 cm3 in AF+HT vs 0.96 ± 0.3 cm3 in AF; P < .05). Left and right atrial effective refractory periods, action potential durations, endo- and epicardial conduction velocities, and measures of AF complexity were comparable between the 2 groups. A 3-dimensional computational model confirmed an increase in AF stability observed in the in vivo experiments associated with increased atrial size. CONCLUSION:In this model of secondary HT, higher AF stability after 2 weeks of RAP is mainly driven by atrial dilatation.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Manninger M,Zweiker D,van Hunnik A,Alogna A,Prassl AJ,Schipke J,Zeemering S,Zirngast B,Schönleitner P,Schwarzl M,Herbst V,Thon-Gutschi E,Huber S,Rohrer U,Ebner J,Brussee H,Pieske BM,Heinzel FR,Verheule S,Antoons G,doi
10.1016/j.hrthm.2018.05.016subject
Has Abstractpub_date
2018-09-01 00:00:00pages
1328-1336issue
9eissn
1547-5271issn
1556-3871pii
S1547-5271(18)30503-4journal_volume
15pub_type
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