2024-03-29T08:39:29Z
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2023-01-16T04:02:21Z
499:960:1165
Verapamil Eliminates the Hierarchical Nature of Activation Frequencies from the Pulmonary Veins to the Atria during Paroxysmal Atrial Fibrillation
Kushiyama, Yasunori
Osaka, Toshiyuki
Yokoyama, Eriko
Hasebe, Hideyuki
Kuroda, Yusuke
Kamiya, Kaichiro
Kodama, Itsuo
open access
This is the author's version of a work that was accepted for publication in Heart Rhythm. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms, may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Heart Rhythm. v.7, n.5, 2010, p.577–p.583, DOI: 10.1016/j.hrthm.2010.01.008
paroxysmal atrial fibrillation
verapamil
dominant frequency
pulmonary vein
atrium
BACKGROUND: There is evidence that verapamil promotes the persistence of paroxysmal atrial fibrillation (AF). Little is known about the underlying mechanisms. OBJECTIVE: The purpose of this study was to determine the effect of verapamil on dominant frequencies (DFs) in the pulmonary veins (PVs) and atria during paroxysmal AF with reference to its potential arrhythmogenicity. METHODS: Forty-three patients with paroxysmal AF were studied. Bipolar electrograms were recorded simultaneously during AF from the right atrial free wall (RAFW), coronary sinus (CS) and three PVs, or two PVs and the left atrial appendage (LAA). The DFs were obtained by fast Fourier transform analysis before and after infusion of verapamil (0.1 mg/kg, intravenously). RESULTS: At baseline, the maximum DF among the PVs (6.9 +/- 0.9 Hz) was significantly higher than the DF in the RAFW (6.2 +/- 0.7 Hz), CS (5.7 +/- 0.5 Hz), or LAA (5.9 +/- 0.7 Hz) (P<.01); there was a substantial PV-to-atrial DF gradient (RAFW 0.7 +/- 0.9, CS 1.1 +/- 0.7, LAA 0.7 +/- 0.9 Hz). Verapamil increased the atrial DF to 6.9 +/- 0.8, 6.6 +/- 0.7, and 7.2 +/- 1.0 Hz in the RAFW, CS, and LAA, respectively (P<.0001) but did not affect the maximum PV DF (7.1 +/- 0.7 Hz). The PV-to-atrial DF gradient was eliminated after verapamil (RAFW 0.2 +/- 0.8, CS 0.5 +/- 0.6, LAA -0.4 +/- 0.8 Hz; P<.01 vs. baseline). CONCLUSION: Verapamil increases the activation frequency in the atria but not in the PVs, eliminating the PV-to-atrial DF gradient during paroxysmal AF.
名古屋大学博士学位論文 学位の種類 : 博士(医学)(課程) 学位授与年月日:平成24年3月26日 櫛山泰規氏の博士論文として提出された
Elsevier
2010-05
eng
doctoral thesis
http://hdl.handle.net/2237/16802
https://nagoya.repo.nii.ac.jp/records/14868
https://doi.org/10.1016/j.hrthm.2010.01.008
1547-5271
Heart Rhythm
7
5
577
583
甲第9559号
博士(医学)
2010-05-01
13901
名古屋大学
Nagoya University
https://nagoya.repo.nii.ac.jp/record/14868/files/k9559.pdf
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2018-02-20