The relation between the atrial blood supply and the complexity of acute atrial fibrillation
Background: Patients with a history of myocardial infarction and coronary artery disease (CAD) have a higher risk of developing AF. Conversely, patients with atrial fibrillation (AF) have a higher risk of developing myocardial infarction, suggesting a link in underlying pathophysiology. The aim of t...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906721000828 |
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| author | Elton A.M.P. Dudink Elham Bidar Judith Jacobs Arne van Hunnik Stef Zeemering Bob Weijs Justin G.L.M. Luermans Bart A.E. Maesen Emile C. Cheriex Jos G. Maessen Jan C.A. Hoorntje Ulrich Schotten Harry J.G.M. Crijns Sander Verheule |
| author_facet | Elton A.M.P. Dudink Elham Bidar Judith Jacobs Arne van Hunnik Stef Zeemering Bob Weijs Justin G.L.M. Luermans Bart A.E. Maesen Emile C. Cheriex Jos G. Maessen Jan C.A. Hoorntje Ulrich Schotten Harry J.G.M. Crijns Sander Verheule |
| author_sort | Elton A.M.P. Dudink |
| collection | DOAJ |
| description | Background: Patients with a history of myocardial infarction and coronary artery disease (CAD) have a higher risk of developing AF. Conversely, patients with atrial fibrillation (AF) have a higher risk of developing myocardial infarction, suggesting a link in underlying pathophysiology. The aim of this study was to assess whether coronary angiographic parameters are associated with a substrate for AF in patients without a history of AF. Methods: During cardiac surgery in 62 patients (coronary artery bypass grafting (CABG;n = 47), aortic valve replacement (AVR;n = 9) or CABG + AVR (n = 6)) without a history of clinical AF (age 65.4 ± 8.5 years, 26.2% female), AF was induced by burst pacing. The preoperative coronary angiogram (CAG) was assessed for the severity of CAD, and the adequacy of atrial coronary blood supply as quantified by a novel scoring system including the location and severity of right coronary artery disease in relation to the right atrial branches. Epicardial mapping of the right atrium (256 unipolar electrodes) was used to assess the complexity of induced AF. Results: There was no association between the adequacy of right atrial coronary blood supply on preoperative CAG and AF complexity parameters. Multivariable analysis revealed that only increasing age (B0.232 (0.030;0.433),p = 0.03) and the presence of 3VD (B3.602 (0.187;7.018),p = 0.04) were independently associated with an increased maximal activation time difference. Conclusions: The adequacy of epicardial right atrial blood supply is not associated with increased complexity of induced atrial fibrillation in patients without a history of clinical AF, while age and the extent of ventricular coronary artery disease are. |
| first_indexed | 2024-12-17T02:36:18Z |
| format | Article |
| id | doaj.art-c0fc77b5796b448fa04dbd678e3e0f93 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-17T02:36:18Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-c0fc77b5796b448fa04dbd678e3e0f932022-12-21T22:06:50ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672021-06-0134100794The relation between the atrial blood supply and the complexity of acute atrial fibrillationElton A.M.P. Dudink0Elham Bidar1Judith Jacobs2Arne van Hunnik3Stef Zeemering4Bob Weijs5Justin G.L.M. Luermans6Bart A.E. Maesen7Emile C. Cheriex8Jos G. Maessen9Jan C.A. Hoorntje10Ulrich Schotten11Harry J.G.M. Crijns12Sander Verheule13Maastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiology, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiothoracic Surgery, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands; Maastricht University and Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Universiteitssingel 50, 6229 ER Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiology, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University and Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Universiteitssingel 50, 6229 ER Maastricht, the NetherlandsMaastricht University and Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Universiteitssingel 50, 6229 ER Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiology, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiology, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiothoracic Surgery, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiology, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiothoracic Surgery, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiology, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University and Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Universiteitssingel 50, 6229 ER Maastricht, the NetherlandsMaastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Department of Cardiology, P. Debyelaan 25, 6229 HX Maastricht, the NetherlandsMaastricht University and Cardiovascular Research Institute Maastricht (CARIM), Department of Physiology, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands; Corresponding author.Background: Patients with a history of myocardial infarction and coronary artery disease (CAD) have a higher risk of developing AF. Conversely, patients with atrial fibrillation (AF) have a higher risk of developing myocardial infarction, suggesting a link in underlying pathophysiology. The aim of this study was to assess whether coronary angiographic parameters are associated with a substrate for AF in patients without a history of AF. Methods: During cardiac surgery in 62 patients (coronary artery bypass grafting (CABG;n = 47), aortic valve replacement (AVR;n = 9) or CABG + AVR (n = 6)) without a history of clinical AF (age 65.4 ± 8.5 years, 26.2% female), AF was induced by burst pacing. The preoperative coronary angiogram (CAG) was assessed for the severity of CAD, and the adequacy of atrial coronary blood supply as quantified by a novel scoring system including the location and severity of right coronary artery disease in relation to the right atrial branches. Epicardial mapping of the right atrium (256 unipolar electrodes) was used to assess the complexity of induced AF. Results: There was no association between the adequacy of right atrial coronary blood supply on preoperative CAG and AF complexity parameters. Multivariable analysis revealed that only increasing age (B0.232 (0.030;0.433),p = 0.03) and the presence of 3VD (B3.602 (0.187;7.018),p = 0.04) were independently associated with an increased maximal activation time difference. Conclusions: The adequacy of epicardial right atrial blood supply is not associated with increased complexity of induced atrial fibrillation in patients without a history of clinical AF, while age and the extent of ventricular coronary artery disease are.http://www.sciencedirect.com/science/article/pii/S2352906721000828Atrial fibrillation complexityAtrial fibrillation substrateCoronary artery disease |
| spellingShingle | Elton A.M.P. Dudink Elham Bidar Judith Jacobs Arne van Hunnik Stef Zeemering Bob Weijs Justin G.L.M. Luermans Bart A.E. Maesen Emile C. Cheriex Jos G. Maessen Jan C.A. Hoorntje Ulrich Schotten Harry J.G.M. Crijns Sander Verheule The relation between the atrial blood supply and the complexity of acute atrial fibrillation International Journal of Cardiology: Heart & Vasculature Atrial fibrillation complexity Atrial fibrillation substrate Coronary artery disease |
| title | The relation between the atrial blood supply and the complexity of acute atrial fibrillation |
| title_full | The relation between the atrial blood supply and the complexity of acute atrial fibrillation |
| title_fullStr | The relation between the atrial blood supply and the complexity of acute atrial fibrillation |
| title_full_unstemmed | The relation between the atrial blood supply and the complexity of acute atrial fibrillation |
| title_short | The relation between the atrial blood supply and the complexity of acute atrial fibrillation |
| title_sort | relation between the atrial blood supply and the complexity of acute atrial fibrillation |
| topic | Atrial fibrillation complexity Atrial fibrillation substrate Coronary artery disease |
| url | http://www.sciencedirect.com/science/article/pii/S2352906721000828 |
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