Differences of Atrial Electrophysiological Properties between Vagal and Sympathetic Type Atrial Fibrillations

Li Wei Lo, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Kazuyoshi Suenari, Cheng Hung Li, Tze Fan Chao, Shih Ann Chen

研究成果: Article同行評審


Introduction: Autonomic modulation of cardiac activities plays an important role in the pathogenesis of atrial fibrillation (AF).The aim of this study was to assess the differences of atrial electrical/structural properties between the patients with vagal and sympathetic AF. Methods: The study included 16 patients (53±12 y/o, male 14)with frequent attacks of symptomatic paroxysmal AF. All cases underwent 24-hour ambulatory Holter monitoring before ablation. Onset of AF accompanied with increased HF component and decreased L/H ratio was designated as vagal AF (Group 1, n=8); whereas decreased HF component and increased L/H ratio was classified as sympathetic AF (Group 2, n=8).Electrical/structural properties were evaluated. Results: All patients had AF originating from PVs. There was a higher incidence of non-PV triggers in Group 2 patients than Group 1 (50%vs.0%, p=0.02). Group 1 had a higher bipolar peak-to-peak voltage of left atrium (LA), longer activation time and smaller LA volume than those of Group 2, whereas electrical and structural properties in the right atrium were similar. After a follow-up of 9±4 months, there was a lower incidence of AF recurrence in Group 1 than Group 2 (0%vs.50%, p=0.02). Conclusion: There is a better electrical property with smaller LA volume in the patients with vagal AF. The LA substrate is worse, and the coexisting non-PV triggers and recurrence following ablation are more prevalent in the patients with sympathetic AF.

頁(從 - 到)272
期刊journal of arrhythmia
出版狀態Published - 2011


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