Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence
Classification of atrial fibrillation (AF) is currently based on clinical characteristics. However, classifying AF using an objective electrophysiological parameter would be more desirable. The aim of this study was to quantify parameters of atrial conduction during sinus rhythm (SR) using an intra-...
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MDPI AG
2021-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/13/2846 |
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| author | Willemijn F. B. van der Does Annejet Heida Lisette J. M. E. van der Does Ad J. J. C. Bogers Natasja M. S. de Groot |
| author_facet | Willemijn F. B. van der Does Annejet Heida Lisette J. M. E. van der Does Ad J. J. C. Bogers Natasja M. S. de Groot |
| author_sort | Willemijn F. B. van der Does |
| collection | DOAJ |
| description | Classification of atrial fibrillation (AF) is currently based on clinical characteristics. However, classifying AF using an objective electrophysiological parameter would be more desirable. The aim of this study was to quantify parameters of atrial conduction during sinus rhythm (SR) using an intra-operative high-resolution epicardial mapping approach and to relate these parameters to clinical classifications of AF. Patients were divided according to the standard clinical classification and spontaneous termination of AF episodes. The HATCH score, a score predictive of AF progression, was calculated, and surface ECGs were evaluated for signs of interatrial block. Conduction disorders mainly differed at Bachmann’s bundle (BB). Activation time (AT) at BB was longer in persistent AF patients (AT-BB: 75 (53–92) ms vs. 55 (40–76) ms, <i>p</i> = 0.017), patients without spontaneous termination of AF episodes (AT-BB: 53.5 (39.6–75.8) ms vs. 72.0 (49.6–80.8) ms, <i>p</i> = 0.009) and in patients with a P-wave duration ≥ 120 ms (64.3 (52.3–93.0) ms vs. 50.5 (39.6–56.6) ms, <i>p</i> = 0.014). HATCH scores also correlated positively to AT-BB (rho 0.326, <i>p</i> = 0.029). However, discriminatory values of electrophysiological parameters, as calculated using ROC-curves, were limited. These results may reflect shortcomings of clinical classifications and further research is needed to establish an objective substrate-based classification of AF. |
| first_indexed | 2024-03-10T10:01:05Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T10:01:05Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d97d6105db5c4bdbbde003e8d3bb4cc42023-11-22T01:57:11ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011013284610.3390/jcm10132846Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation PersistenceWillemijn F. B. van der Does0Annejet Heida1Lisette J. M. E. van der Does2Ad J. J. C. Bogers3Natasja M. S. de Groot4Department of Cardiology, Erasmus Medical Center, 3015 CN Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus Medical Center, 3015 CN Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus Medical Center, 3015 CN Rotterdam, The NetherlandsDepartment of Cardiothoracic Surgery, Erasmus Medical Center, 3015 CN Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus Medical Center, 3015 CN Rotterdam, The NetherlandsClassification of atrial fibrillation (AF) is currently based on clinical characteristics. However, classifying AF using an objective electrophysiological parameter would be more desirable. The aim of this study was to quantify parameters of atrial conduction during sinus rhythm (SR) using an intra-operative high-resolution epicardial mapping approach and to relate these parameters to clinical classifications of AF. Patients were divided according to the standard clinical classification and spontaneous termination of AF episodes. The HATCH score, a score predictive of AF progression, was calculated, and surface ECGs were evaluated for signs of interatrial block. Conduction disorders mainly differed at Bachmann’s bundle (BB). Activation time (AT) at BB was longer in persistent AF patients (AT-BB: 75 (53–92) ms vs. 55 (40–76) ms, <i>p</i> = 0.017), patients without spontaneous termination of AF episodes (AT-BB: 53.5 (39.6–75.8) ms vs. 72.0 (49.6–80.8) ms, <i>p</i> = 0.009) and in patients with a P-wave duration ≥ 120 ms (64.3 (52.3–93.0) ms vs. 50.5 (39.6–56.6) ms, <i>p</i> = 0.014). HATCH scores also correlated positively to AT-BB (rho 0.326, <i>p</i> = 0.029). However, discriminatory values of electrophysiological parameters, as calculated using ROC-curves, were limited. These results may reflect shortcomings of clinical classifications and further research is needed to establish an objective substrate-based classification of AF.https://www.mdpi.com/2077-0383/10/13/2846atrial fibrillationconduction disturbanceshigh-resolution mappingAF persistence |
| spellingShingle | Willemijn F. B. van der Does Annejet Heida Lisette J. M. E. van der Does Ad J. J. C. Bogers Natasja M. S. de Groot Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence Journal of Clinical Medicine atrial fibrillation conduction disturbances high-resolution mapping AF persistence |
| title | Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence |
| title_full | Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence |
| title_fullStr | Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence |
| title_full_unstemmed | Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence |
| title_short | Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence |
| title_sort | conduction disorders during sinus rhythm in relation to atrial fibrillation persistence |
| topic | atrial fibrillation conduction disturbances high-resolution mapping AF persistence |
| url | https://www.mdpi.com/2077-0383/10/13/2846 |
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