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Atrial electrical remodeling

Dominik Linz, R Doug McEvoy, Martin R Cowie, Virend K Somers, Stanley Nattel, Patrick Lévy, Jonathan M Kalman, Prashanthan Sanders
Importance: Obstructive sleep apnea (OSA) is the most common clinically significant breathing abnormality during sleep. It is highly prevalent among patients with atrial fibrillation (AF), and it promotes arrhythmogenesis and impairs treatment efficacy. Observations: The prevalence of OSA ranges from 3% to 49% in population-based studies and from 21% to 74% in patients with AF. Diagnosis and treatment of OSA in patients with AF requires a close interdisciplinary collaboration between electrophysiologists, cardiologists, and sleep specialists...
March 14, 2018: JAMA Cardiology
Bernard Iung, Antoine Leenhardt, Fabrice Extramiana
Atrial fibrillation (AF) is frequent in patients with rheumatic mitral stenosis (MS). Pressure overload leads to marked structural and electrical remodelling of left atrium. The frequency of persistent AF increases with age and paroxysmal, asymptomatic, AF seems even more frequent. The occurrence of AF worsens the haemodynamic tolerance of MS and markedly increases the risk of thromboembolic events. AF has a negative impact on the natural history of MS and on its outcome after commissurotomy. The respective indications of rhythm and rate control should be adapted to patient characteristics, particularly the consequences of MS, and take into account the high risk of recurrence of AF...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
Dominik Linz, Mathias Hohl, Adrian D Elliott, Dennis H Lau, Felix Mahfoud, Murray D Esler, Prashanthan Sanders, Michael Böhm
Renal afferent and efferent sympathetic nerves are involved in the regulation of blood pressure and have a pathophysiological role in hypertension. Additionally, several conditions that frequently coexist with hypertension, such as heart failure, obstructive sleep apnea, atrial fibrillation, renal dysfunction, and metabolic syndrome, demonstrate enhanced sympathetic activity. Renal denervation (RDN) is an approach to reduce renal and whole body sympathetic activation. Experimental models indicate that RDN has the potential to lower blood pressure and prevent cardio-renal remodeling in chronic diseases associated with enhanced sympathetic activation...
February 10, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Lilei Yu, Guannan Meng, Bing Huang, Xiaoya Zhou, Stavros Stavrakis, Menglong Wang, Xuefei Li, Liping Zhou, Yuhong Wang, Meng Wang, Zhenya Wang, Jielin Deng, Sunny S Po, Hong Jiang
BACKGROUND: Emerging evidence indicates gut microbes and their products could activate the autonomic nervous system (ANS), which plays important roles in the initiation and maintenance of atrial fibrillation (AF). Trimethylamine N-oxide (TMAO), a metabolite derived from gut microbes, is associated with cardiovascular diseases. The present study aimed to investigate the role of TMAO in the progression of AF. METHODS: In part 1: TMAO or saline was locally injected into 4 major atrial ganglionated plexi (GP) to clarify its effect on cardiac ANS and AF inducibility in normal canines...
March 15, 2018: International Journal of Cardiology
Justus M B Anumonwo, Todd Herron
Anatomical evidence in several species shows highly heterogeneous fat distribution in the atrial and ventricular myocardium. Atrial appendages have fat deposits, and more so on the posterior left atrium. Although such fat distributions are considered normal, fatty infiltration is regarded arrhythmogenic, and various cardiac pathophysiological conditions show excess myocardial fat deposits, especially in the epicardium. Hypotheses have been presented for the physiological and pathophysiological roles of epicardial fat, however this issue is poorly understood...
2018: Frontiers in Physiology
Alexander Klesen, Dorothee Jakob, Ramona Emig, Peter Kohl, Ursula Ravens, Rémi Peyronnet
Fibrotic areas in cardiac muscle-be it in ventricular or atrial tissue-are considered as obstacles for conduction of the excitatory wave and can therefore facilitate re-entry, which may contribute to the sustenance of cardiac arrhythmias. Persistence of one of the most frequent arrhythmias, atrial fibrillation (AF), is accompanied by enhanced atrial fibrosis. Any kind of myocardial perturbation, whether via mechanical stress or ischemic damage, inflammation, or irregular and high-frequency electrical activity, activates fibroblasts...
February 1, 2018: Herzschrittmachertherapie & Elektrophysiologie
Xuewen Wang, Guangping Li
INTRODUCTION: Activation of the renin-angiotensin system (RAS) plays an important role in atrial electrical remodeling (AER). The purpose of the present study was to evaluate the effects of irbesartan on cardiac sodium current (INa) in a canine model of atrial fibrillation. MATERIALS AND METHODS: Eighteen dogs were randomized into sham, pacing or pacing+irbesartan groups ( n = 6 in each group). The dogs in the pacing and irbesartan group were paced at 500 bpm for two weeks...
January 2018: Journal of the Renin-angiotensin-aldosterone System: JRAAS
Shinya Yamada, Man-Cai Fong, Ya-Wen Hsiao, Shih-Lin Chang, Yung-Nan Tsai, Li-Wei Lo, Tze-Fan Chao, Yenn-Jiang Lin, Yu-Feng Hu, Fa-Po Chung, Jo-Nan Liao, Yao-Ting Chang, Hsing-Yuan Li, Satoshi Higa, Shih-Ann Chen
BACKGROUND: Myocardial infarction increases the risk of heart failure (HF) and atrial fibrillation. Renal denervation (RDN) might suppress the development of atrial remodeling. This study aimed to elucidate the molecular mechanism of RDN in the suppression of atrial fibrillation in a HF model after myocardial infarction. METHODS AND RESULTS: HF rabbits were created 4 weeks after coronary ligation. Rabbits were classified into 3 groups: normal control (n=10), HF (n=10), and HF-RDN (n=6)...
January 22, 2018: Journal of the American Heart Association
Brian Martin, Beth Ann Gabris-Weber, Rajiv Reddy, Guillermo Romero, Ansuman Chattopadhyay, Guy Salama
BACKGROUND: 'Healthy' aging drives structural and functional changes in the heart including maladaptive electrical remodeling, fibrosis and inflammation, which lower the threshold for cardiovascular diseases such as heart failure (HF) and atrial fibrillation (AF). Despite mixed results in recent clinical trials, Relaxin-therapy for 2-days could reduce mortality by 37% at 180-days post-treatment, in patients with acute decompensated HF. Relaxin's short life-span (hours) but long-lasting protective actions led us to test the hypothesis that relaxin acts at a genomic level to reverse maladaptive remodeling in aging and HF...
2018: PloS One
Pan Pan Xia, Lian Jing Li, Run Di Qi, Jiao Jiao Shi, Wei Zhu Ju, Ming Long Chen
OBJECTIVE: Hypertension is a significant risk factor for atrial fibrillation (AF). The role of pulmonary vein (PV) remodeling in the mechanistic association between hypertension and AF is not definitive. In this study, we aimed to identify changes in the electrophysiology and histology in PVs in two-kidney, one-clip (2K1C) hypertensive rats. METHODS: Fifty male Sprague-Dawley rats were classified into the 2K1C and sham-operated groups. The systolic blood pressure was measured every 2 weeks...
January 17, 2018: Anatolian Journal of Cardiology
Maurizio Acampa, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Andrea Lo Monaco, Giuseppe Martini
BACKGROUND: In the general population the leading cause of cardioembolic stroke is atrial fibrillation (AF). A silent AF is also the possible cause of many cryptogenic strokes. P wave dispersion (PWD), a predictor of AF, has been proposed as a marker of silent AF occurrence in these strokes. PWD correlates with high-sensitive C-reactive protein levels reflecting the role of inflammation in promoting a slowed and inhomogeneous atrial conduction. Statins have a multitude of additional effects beyond lipid lowering, in particular anti-inflammatory effects that may influence atrial conduction...
January 10, 2018: Cardiovascular & Hematological Disorders Drug Targets
Adina Elena Stanciu, Radu Gabriel Vatasescu, Marcel Marian Stanciu, Nafija Serdarevic, Maria Dorobantu
PURPOSE: Signaling pathways involved in electrical, structural and contractile remodeling processes behind development and progression of atrial fibrillation (AF) have not been completely elucidated, but it seems to be related to complex interactions among neurohormonal and cellular mediators. We aimed to investigate interleukin-6 (IL-6), transforming growth factor-beta1 (TGF-β1), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), as biomarkers of atrial remodeling, in patients with paroxysmal and persistent AF, and their correlation with N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and left atrial (LA) diameter...
January 8, 2018: Cytokine
Aleksei S Kovalev, Leo A Bockeria, Andrey G Filatov
Atrial fibrillation (AF) is the most common arrhythmia in the population. Still there is no unity in understanding of mechanisms and their influence on catheter ablation results. In our study we tried to evaluate accurate initial quantitative indicators of electromechanical remodeling that can border patients from expected good to expected poor results of catheter ablation. We performed electroanatomical mapping and ablation procedures in 94 patient (45 female) in 2012 with 3-year follow-up period. The target points were left atria surface area, complex fragmentation atrial electrograms (CFAE) duration and surface area...
February 2017: Journal of Atrial Fibrillation
Elisa Gambini, Gianluca Lorenzo Perrucci, Beatrice Bassetti, Gabriella Spaltro, Giulia Campostrini, Maria Chiara Lionetti, Alberto Pilozzi, Federico Martinelli, Andrea Faruggia, Dario DiFrancesco, Andrea Barbuti, Giulio Pompilio
Atrial fibrillation (AF) is characterized by electrical, contractile, and structural remodeling mediated by interstitial fibrosis. It has been shown that human cardiac mesenchymal progenitor cells (CMPCs) can be differentiated into endothelial, smooth muscle, and fibroblast cells. Here, we have investigated, for the first time, the contribution of CMPCs in the fibrotic process occurring in AF. As expected, right auricolae samples displayed significantly higher fibrosis in AF vs control (CTR) patients. In tissue samples of AF patients only, double staining for c-kit and the myofibroblast marker α-smooth muscle actin (α-SMA) was detected...
November 27, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
Eva Z Hesselkilde, Helena Carstensen, Maria M Haugaard, Jonas Carlson, Steen Pehrson, Thomas Jespersen, Rikke Buhl, Pyotr G Platonov
BACKGROUND: Atrial fibrillatory cycle length has been considered one of the indices of atrial electrical remodelling during atrial fibrillation (AF), which can be assessed from surface ECG by computer-assisted calculation of atrial fibrillatory rate (AFR). Horses have been suggested as a bona fide model for AF studies since horses too, develop lone AF, however data on AF characteristics in horses are extremely sparse and non-invasive characterization of AF complexity using surface ECG processing has not been reported...
December 8, 2017: BMC Cardiovascular Disorders
Haibo Ni, Dominic G Whittaker, Wei Wang, Wayne R Giles, Sanjiv M Narayan, Henggui Zhang
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Developing effective and safe anti-AF drugs remains an unmet challenge. Simultaneous block of both atrial-specific ultra-rapid delayed rectifier potassium (K+ ) current (IKur ) and the Na+ current (INa ) has been hypothesized to be anti-AF, without inducing significant QT prolongation and ventricular side effects. However, the antiarrhythmic advantage of simultaneously blocking these two channels vs. individual block in the setting of AF-induced electrical remodeling remains to be documented...
2017: Frontiers in Physiology
Yoshio Takemoto, Rafael J Ramirez, Kuljeet Kaur, Oscar Salvador-Montañés, Daniela Ponce-Balbuena, Roberto Ramos-Mondragón, Steven R Ennis, Guadalupe Guerrero-Serna, Omer Berenfeld, José Jalife
BACKGROUND: The aldosterone inhibitor eplerenone (EPL) has been shown to reduce the incidence of atrial fibrillation (AF) in patients with systolic heart failure, but the mechanism is unknown. OBJECTIVES: This study hypothesized that by reducing atrial dilation and fibrosis in the absence of heart failure, EPL also reduces AF burden and prevents AF perpetuation. METHODS: The authors conducted a randomized controlled study in 34 sheep that were atrially tachypaced (13 ± 1 week)...
December 12, 2017: Journal of the American College of Cardiology
Fei Zhang, Yuhao Bian, Lei Huang, Wenbin Fan
Structural and electrical remodeling within the atrium mediate the pathogenesis of atrial fibrillation (AF). Two key genes that sever a role in this remodeling are connexin 40 (Cx40) and potassium voltage-gated channel subfamily A member 5 (KCNA5), respectively. Electrical remodeling is considered to induce structural remodeling during AF. In the present study, the left atrial appendage section and atrial myocytes of patients with AF were evaluated. It was observed that Cx40 and KCNA5 mRNA (P<0.05) and protein (P<0...
November 2017: Experimental and Therapeutic Medicine
Michael R Gold, Yinghong Yu, Nicholas Wold, John D Day
BACKGROUND: Pacing at sites with late electrical activation or greater interventricular delay is associated with improvement in measures of cardiac resynchronization therapy (CRT) response, primarily reverse remodeling. However, little is known about whether such lead positions improve heart failure (HF) clinical outcomes. OBJECTIVE: The purpose of this study was to assess the association between interventricular electrical delay and HF clinical outcomes. METHODS: The Pacing Evaluation-Atrial SUpport Study was a multicenter randomized trial of patients undergoing CRT-defibrillator implantation...
December 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Anna Degiovanni, Enrico Boggio, Eleonora Prenna, Chiara Sartori, Federica De Vecchi, Paolo N Marino
BACKGROUND: Diastolic dysfunction promotes atrial fibrillation (AF) inducing left atrial (LA) remodeling, with chamber dilation and fibrosis. Predominance of LA phasic conduit (LAC) function should reflect not only chamber alterations but also underlying left ventricular (LV) filling impairment. Thus, LAC was tested as possible predictor of early AF relapse after electrical cardioversion (EC). METHODS: 96 consecutive patients, who underwent EC for persistent non-valvular AF, were prospectively enrolled...
November 27, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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