PMID- 33357582
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20210818
IS  - 2405-5018 (Electronic)
IS  - 2405-500X (Linking)
VI  - 6
IP  - 14
DP  - 2020 Dec
TI  - Conduction Heterogeneity: Impact of Underlying Heart Disease and Atrial 
      Fibrillation.
PG  - 1844-1854
LID - S2405-500X(20)30981-6 [pii]
LID - 10.1016/j.jacep.2020.09.030 [doi]
AB  - OBJECTIVES: The goal of this study is to investigate the impact of various 
      underlying heart diseases (UHDs) and prior atrial fibrillation (AF) episodes on 
      conduction heterogeneity. BACKGROUND: It is unknown whether intra-atrial 
      conduction during sinus rhythm differs between various UHD or is influenced by AF 
      episodes. METHODS: Epicardial sinus rhythm mapping of the right atrium, 
      Bachmann's bundle (BB), left atrium and pulmonary vein area was performed in 447 
      participants (median age: 67 [interquartile range (IQR): 59 to 73] years) with or 
      without AF undergoing cardiac surgery for ischemic heart disease, (ischemic and) 
      valvular heart disease, or congenital heart disease. Conduction times (CTs) were 
      defined as Delta local activation time between 2 adjacent electrodes and used to 
      assess frequency (CTs >/= 4 ms) and magnitude of conduction disorders (in 
      increments of 10 ms). RESULTS: When comparing the 3 types of UHD, there were no 
      differences in frequencies and magnitude of CTs at all locations (p >/= 0.017 and 
      p >/= 0.005, respectively). Prior AF episodes were associated with conduction 
      slowing throughout both atria (14.9% [IQR: 11.8 to 17.0] vs. 12.8% [IQR: 10.9 to 
      14.6]; p < 0.001). At BB, CTs with magnitudes >/=30 ms were more common in patients 
      with AF (n = 56.2% vs. n = 36.0%; p < 0.004). CONCLUSIONS: UHD has no impact on 
      the frequency and severity of conduction disorders. AF episodes are associated 
      with more conduction disorders throughout both atria and with more severe 
      conduction disorders at BB. The next step will be to determine the relevance of 
      these conduction disorders for AF development and maintenance.
CI  - Copyright (c) 2020 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Heida, Annejet
AU  - Heida A
AD  - Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
FAU - van der Does, Willemijn F B
AU  - van der Does WFB
AD  - Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
FAU - van Staveren, Lianne N
AU  - van Staveren LN
AD  - Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
FAU - Taverne, Yannick J H J
AU  - Taverne YJHJ
AD  - Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, the 
      Netherlands.
FAU - Roos-Serote, Maarten C
AU  - Roos-Serote MC
AD  - Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
FAU - Bogers, Ad J J C
AU  - Bogers AJJC
AD  - Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, the 
      Netherlands.
FAU - de Groot, Natasja M S
AU  - de Groot NMS
AD  - Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands. 
      Electronic address: n.m.s.degroot@erasmusmc.nl.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JACC Clin Electrophysiol
JT  - JACC. Clinical electrophysiology
JID - 101656995
SB  - IM
CIN - JACC Clin Electrophysiol. 2020 Dec;6(14):1855-1857. PMID: 33357583
MH  - Aged
MH  - *Atrial Fibrillation/epidemiology
MH  - Epicardial Mapping
MH  - Heart Atria
MH  - Heart Conduction System
MH  - Heart Rate
MH  - Humans
MH  - Middle Aged
OTO - NOTNLM
OT  - atrial fibrillation
OT  - cardiac surgery
OT  - conduction disorders
OT  - heart disease
OT  - sinus rhythm
COIS- Author Disclosures Dr. de Groot is supported by funding grants from CVON-AFFIP 
      (914728), NWO-Vidi (91717339), Biosense Webster USA (ICD 783454), and Medical 
      Delta. This research (IIS-331 Phase 2) was conducted with financial support from 
      the Investigator-Initiated Study Program of Biosense Webster, Inc. All other 
      authors have reported that they have no relationships relevant to the contents of 
      this paper to disclose.
EDAT- 2020/12/29 06:00
MHDA- 2021/08/19 06:00
CRDT- 2020/12/28 10:18
PHST- 2020/05/15 00:00 [received]
PHST- 2020/08/25 00:00 [revised]
PHST- 2020/09/22 00:00 [accepted]
PHST- 2020/12/28 10:18 [entrez]
PHST- 2020/12/29 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
AID - S2405-500X(20)30981-6 [pii]
AID - 10.1016/j.jacep.2020.09.030 [doi]
PST - ppublish
SO  - JACC Clin Electrophysiol. 2020 Dec;6(14):1844-1854. doi: 
      10.1016/j.jacep.2020.09.030.