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Electroanatomic remodelling of the pulmonary veins associated with age.
- Source :
-
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2012 Jan; Vol. 14 (1), pp. 46-51. Date of Electronic Publication: 2011 Aug 18. - Publication Year :
- 2012
-
Abstract
- Aims: Increasing age is a significant risk factor for developing atrial fibrillation (AF). Pulmonary vein (PV) triggers are critical in the mechanism of AF, but little is known of the substrate changes that occur within the PVs with ageing. Therefore, we sought to identify whether ageing is associated with electroanatomic changes within the pulmonary veins.<br />Methods and Results: Twenty-five patients undergoing ablation for left-sided supraventricular tachycardia had high-density 3D electroanatomic maps of all four PVs created. Patients were divided into two groups: group 1 aged <50 years and group 2 aged >50 years. Mean-voltage (MV), % low-voltage (LV < 0.5 mV), conduction, signal complexity, and PV muscle sleeve length and diameter were assessed. Age was 33 ± 8 vs. 66 ± 8 years for groups 1 and 2, respectively (P < 0.001). Group 2 demonstrated: (i) lower MV within the PVs (1.66 ± 1.1 vs. 1.88 ± 1.1 mV, P < 0.001); (ii) increased % LV (5.0 vs. 1.1%, P < 0.001), and increased voltage heterogeneity within the PVs (65 ± 14 vs. 55 ± 8%, P < 0.05); (iii) regional and global conduction slowing in the PVs; and (iv) increased % complex signals within the PVs (1.4 vs. 0.4%, P = 0.009). There was no difference in PV sleeve length or diameter.<br />Conclusion: Increasing age is associated with PV electroanatomic changes characterized by a significant reduction in PV voltage, conduction slowing, and increasing signal complexity. These observations provide new insights into the potential mechanisms behind the increased prevalence of AF with advancing age.
- Subjects :
- Adult
Age Factors
Aged
Catheter Ablation
Female
Heart Atria physiopathology
Heart Atria surgery
Humans
Male
Middle Aged
Pulmonary Veins physiopathology
Pulmonary Veins surgery
Tachycardia, Supraventricular physiopathology
Tachycardia, Supraventricular surgery
Treatment Outcome
Young Adult
Aging physiology
Pulmonary Veins anatomy & histology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2092
- Volume :
- 14
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 21856675
- Full Text :
- https://doi.org/10.1093/europace/eur275