Clinical significance of the atrial fibrillation threshold in patients with paroxysmal atrial fibrillation

被引:8
作者
Inoue, K [1 ]
Shirayama, T [1 ]
Shiraishi, H [1 ]
Matoba, Y [1 ]
Imai, H [1 ]
Inoue, D [1 ]
Nakagawa, M [1 ]
机构
[1] Kyoto Prefectural Univ Med, Dept Med 2, Kamigyo Ku, Kyoto 6028566, Japan
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2001年 / 24卷 / 05期
关键词
atrial fibrillation threshold; diagnostic accuracy;
D O I
10.1046/j.1460-9592.2001.00796.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
AF threshold and the other electrophysiological parameters were measured to quantify atrial vulnerability in patients with paroxysmal atrial fibrillation (PAF, n = 47), and those M without AF (non-PAF, n = 25). Stimulations were delivered at the right atrial appendage with a basic cycle length of 500 ms. The PAF group had a significantly larger percentage of maximum atrial fragmentation (%MAF, non-PAF: mean +/- SD = 149 +/- 29%, PAF: 166 +/- 26%, P = 0.009), fragmented atrial activity zone (FAZ, non-PAF: median 0 ms, interquartile range 0-20 ms, PAF: 20 ms, 10-40 ms, P = 0.008). Atrial fibrillation threshold (AF threshold, non-PAF: median 11 mA, interquartile range 6-21 mA, PAF: 5 mA, 3-6; mA, P < 0.001) was smaller in the PAF group than in the non-PAF group. Sensitivity, specificity, and positive predictive value of electrophysiological parameters were as follows, respectively: %MAF (cut off at 150%, 78%, 52%, 76%), FAZ (cut off at 20 ms, 47%, 84%, 85%), AF threshold (cut off at 10 mA, 94%, 60%, 81 %). There were no statistically significant differences between the non-PAF and PAF groups in the other parameters (effective refractory period, interatrial conduction time, maximum conduction delay, conduction delay zone, repetitive atrial firing zone, wavelength index), that were not specific for PAF. In conclusion, the AF threshold could be a useful indicator to evaluate atrial vulnerability in patients with AF.
引用
收藏
页码:796 / 805
页数:10
相关论文
共 37 条
[1]  
ALLESSIE M, 1982, ATRIAL FIBRILLATION, P44
[2]   THE USE OF ATRIAL-PACING TO INDUCE ATRIAL-FIBRILLATION AND FLUTTER [J].
BRIGNOLE, M ;
MENOZZI, C ;
SARTORE, B ;
BARRA, M ;
MONDUCCI, I .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 1986, 12 (01) :45-54
[3]   ELECTROPHYSIOLOGIC STUDIES IN ATRIAL-FIBRILLATION - SLOW CONDUCTION OF PREMATURE IMPULSES - A POSSIBLE MANIFESTATION OF THE BACKGROUND FOR REENTRY [J].
COSIO, FG ;
PALACIOS, J ;
VIDAL, JM ;
COCINA, EG ;
GOMEZSANCHEZ, MA ;
TAMARGO, L .
AMERICAN JOURNAL OF CARDIOLOGY, 1983, 51 (01) :122-130
[4]   MECHANISM AND CLINICAL-SIGNIFICANCE OF ATRIAL REPETITIVE RESPONSES IN MAN [J].
COSIO, FG ;
LLOVET, A ;
VIDAL, JM .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1983, 6 (01) :53-59
[5]   Dispersion of repolarization in paroxysmal atrial fibrillation [J].
Diker, E ;
Özdemir, M ;
Aydogdu, S ;
Tezcan, UK ;
Korkmaz, U ;
Kütük, E ;
Göksel, S .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 1998, 63 (03) :281-286
[6]   DIAGNOSTIC IMPLICATIONS OF ATRIAL VULNERABILITY [J].
ENGEL, TR ;
LUCK, JC ;
LEDDY, CL ;
DELCGONZALEZ, A .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1979, 2 (02) :208-214
[7]   Zones of atrial vulnerability - Relationships to basic cycle length [J].
Friedman, HS ;
Sinha, B ;
Tun, A ;
Pasha, R ;
Sharafkhaneh, A ;
Bharadwaj, A .
CIRCULATION, 1996, 94 (06) :1456-1464
[8]   INDEPENDENT AND INTERACTIVE EFFECTS OF DIGOXIN AND QUINIDINE ON THE ATRIAL-FIBRILLATION THRESHOLD IN DOGS [J].
GOLD, RL ;
BREN, GB ;
KATZ, RJ ;
VARGHESE, PJ ;
ROSS, AM .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1985, 6 (01) :119-123
[9]   Wavelength and atrial vulnerability: an endocavitary approach in humans [J].
Graux, P ;
Carlioz, R ;
Rivat, P ;
Bera, J ;
Guyomar, Y ;
Dutoit, A .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1998, 21 (01) :202-208
[10]   VENTRICULAR VULNERABILITY DURING ACUTE CORONARY OCCLUSION [J].
HAN, J .
AMERICAN JOURNAL OF CARDIOLOGY, 1969, 24 (06) :857-&