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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Circulation
2014 ; 129
(14
): 1472-82
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Dominant frequency increase rate predicts transition from paroxysmal to long-term
persistent atrial fibrillation
#MMPMID24463369
Martins RP
; Kaur K
; Hwang E
; Ramirez RJ
; Willis BC
; Filgueiras-Rama D
; Ennis SR
; Takemoto Y
; Ponce-Balbuena D
; Zarzoso M
; O'Connell RP
; Musa H
; Guerrero-Serna G
; Avula UM
; Swartz MF
; Bhushal S
; Deo M
; Pandit SV
; Berenfeld O
; Jalife J
Circulation
2014[Apr]; 129
(14
): 1472-82
PMID24463369
show ga
BACKGROUND: Little is known about the mechanisms underlying the transition from
paroxysmal to persistent atrial fibrillation (AF). In an ovine model of
long-standing persistent AF we tested the hypothesis that the rate of electric
and structural remodeling, assessed by dominant frequency (DF) changes,
determines the time at which AF becomes persistent. METHODS AND RESULTS:
Self-sustained AF was induced by atrial tachypacing. Seven sheep were euthanized
11.5±2.3 days after the transition to persistent AF and without reversal to sinus
rhythm; 7 sheep were euthanized after 341.3±16.7 days of long-standing persistent
AF. Seven sham-operated animals were in sinus rhythm for 1 year. DF was monitored
continuously in each group. Real-time polymerase chain reaction, Western
blotting, patch clamping, and histological analyses were used to determine the
changes in functional ion channel expression and structural remodeling. Atrial
dilatation, mitral valve regurgitation, myocyte hypertrophy, and atrial fibrosis
occurred progressively and became statistically significant after the transition
to persistent AF, with no evidence for left ventricular dysfunction. DF increased
progressively during the paroxysmal-to-persistent AF transition and stabilized
when AF became persistent. Importantly, the rate of DF increase correlated
strongly with the time to persistent AF. Significant action potential duration
abbreviation, secondary to functional ion channel protein expression changes
(CaV1.2, NaV1.5, and KV4.2 decrease; Kir2.3 increase), was already present at the
transition and persisted for 1 year of follow up. CONCLUSIONS: In the sheep model
of long-standing persistent AF, the rate of DF increase predicts the time at
which AF stabilizes and becomes persistent, reflecting changes in action
potential duration and densities of sodium, L-type calcium, and inward rectifier
currents.