Sinus node dysfunction in atrial fibrillation patients: The evidence of regional atrial substrate remodelling

Hung Yu Chang, Yenn Jiang Lin, Li Wei Lo, Shih Lin Chang, Yu Feng Hu, Cheng Hung Li, Tze Fan Chao, Wei Hsian Yin, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Aims It remains unclear as to whether regional atrial substrates of certain areas of the atrium in patients with atrial fibrillation (AF) can be related to sinoatrial node dysfunction. We investigated the relationship between the biatrial substrate characteristics and sinus node function in these patients. Methods and results The study enrolled 34 patients (aged 57 ± 11 years old; 20 males) who underwent catheter ablation for symptomatic paroxysmal AF. Sinus node dysfunction was defined as having corrected sinus node recovery time longer than 550 ms. Atrial substrate analyses of both atria and atrial conductive properties were investigated in patients with (Group 1) and without sinus node dysfunction (Group 2). The mean global bipolar voltage of both atria and the atrial refractory period were similar between the two groups. Regional analysis showed that the mean bipolar voltage for patients in Group 1 was lower than in Group 2 (1.0 ± 0.3 vs. 2.1 ± 0.7 mV, P < 0.001) only in the sinus node region, while the electrophysiological properties were similar for both groups in other anatomic regions of both atria. The right atrial total activation time was significantly longer (97 ± 9 vs. 89 ± 10 ms, P = 0.023) and the conduction velocity along the crista terminalis was significantly slower (1.0 ± 0.2 vs. 1.2 ± 0.3 m/s, P = 0.019) in Group 1 patients than in Group 2 patients. Conclusion In patients with AF, regional atrial remodelling near the sinus node area was associated with sinus node dysfunction.

Original languageEnglish
Pages (from-to)205-211
Number of pages7
Issue number2
StatePublished - Feb 2013


  • Atrial fibrillation
  • Catheter ablation
  • Mapping
  • Sinus node


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