Abstract:
BACKGROUND:The acute effect of atrial fibrillation (AF) on the atrial effective refractory period (ERP) in humans is unknown. METHODS AND RESULTS:In 20 patients without structural heart disease, the atrial ERP was measured before and after pacing-induced AF at drive cycle lengths of 350 and 500 ms. Immediately after spontaneous AF conversion, the post-AF ERP was measured. The pre-AF ERPs at 350 and 500 ms were 206 +/- 23 and 216 +/- 17 ms, respectively. The time to spontaneous conversion of AF was 7.3 +/- 1.9 minutes. The first post-AF ERPs at drive cycle lengths of 350 and 500 ms were 175 +/- 30 ms (P < .0001 versus pre-AF) and 191 +/- 30 ms (P < .0001 versus pre-AF), respectively. The post-AF ERP returned to the pre-AF ERP value after a mean of 8.4 +/- 0.3 minutes. In 15 patients, during the determination of the post-AF ERP, secondary episodes of AF lasting 1 +/- 1.5 minutes were reinduced 6 +/- 3 times per patient. There was a significant inverse logarithmic relationship between the time to reinduction of AF and the duration of secondary episodes of AF (P < .0001, r = 5). CONCLUSIONS:In humans, several minutes of induced AF is sufficient to shorten the ERP for up to approximately 8 minutes. The temporal recovery of the ERP is reflected in progressively shorter episodes of reinduced AF. These data imply that AF transiently shortens the atrial wavelength and suggest a mechanism by which AF may perpetuate itself.
journal_name
Circulationjournal_title
Circulationauthors
Daoud EG,Bogun F,Goyal R,Harvey M,Man KC,Strickberger SA,Morady Fdoi
10.1161/01.cir.94.7.1600subject
Has Abstractpub_date
1996-10-01 00:00:00pages
1600-6issue
7eissn
0009-7322issn
1524-4539journal_volume
94pub_type
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