Tachycardia Induced Electrical Remodeling of the Atria and the Autonomic Nervous System in Goats.

Autor: Blaauw, Yuri, Tieleman, Robert G., Brouwer, Jan, Van Den Berg, Maarten P., De Kam, Pieter J., De Langen, Cees D. J., Haaksma, Jaap, Grandjean, Jan G., Patberg, Kornelis W., Van Gelder, Isabelle C., Crijns, Harry J. G. M.
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Zdroj: Pacing & Clinical Electrophysiology; Nov1999, Vol. 22 Issue 11, p1656-1667, 12p, 1 Diagram, 3 Charts, 5 Graphs
Abstrakt: Atrial fibrillation (AF) shortens the atrial effective refractory period (AERP). To investigate the role of the autonomic nervous system during this so-called electrical remodeling of the atria (ERA) and during recovery from ERA we analyzed heart rate variability (HRV). In 12 goats atrioventricular (300:150 beats/min) pacing was performed for 24 hours, interrupted at 4, 8, 16, and 24 hours for recording of 500 atrial (AA) intervals during sinus rhythm and measurement of the AERP430 ms at 7.4 ± 0.6 sites. After 24 hours, pacing was stopped and the electrophysiological study and recording of the AA intervals was repeated at 4, 8, 16, and 24 hours after cessation of pacing. Time- and frequency-domain parameters were computed from each 500 AA interval recording. After 24 hours of rapid pacing the AERP had shortened significantly (147 ± 5.6 to 102 ± 6.4 ms, P < 0.0001). No significant changes in HRV and dispersion of refractoriness (ΔAERP) (47 ± 7.1 to 44 ± 4.2 ms) were observed. After cessation of pacing, the AERP prolonged again (102 ± 6.4 to 135 ± 8.8 ms, P < 0.0001) and was paralleled by a significant increase in ΔAERP (44 ± 4.2 to 63 ± 7.1 ms, P - 0.01). Furthermore, HRV increased significantly. At each time point an inverse relation between the logarithmically transformed vagal parameter HF (lnHF) and AERP was observed. We calculated the mean lnHF for each goat using all time points and used the median value to divide the 12 goats into high and low vagal tone groups. We compared the degree of ERA and recovery from ERA for both groups. The AERP shortened 47.4 ± 6.5 versus 43.0 ± 5.0 ms (NS) for goats with high and low vagal tone, respectively. During recovery from ERA the AERP lengthened 23.6 ± 4.0 versus 42.5 ± 1.7 ms (P = 0.001) for goats with high and low vagal tone, respectively. Multivariate regression analysis indicated a short AERP as t... [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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