Arrhythmias & electrophysiology
Autonomic modulation impacts conduction velocity dynamics and wavefront propagation in the left atrium
Authors' conclusion
Atrial CV dynamics is affected by fibrosis burden and influenced by autonomic modulation which enhances CV heterogeneity and distribution of pivot points.
Study context
- Population
- Patients undergoing ablation for persistent atrial fibrillation (AF)
- Participants
- 54 patients
- Comparison
- Autonomic modulation and voltage zones vs conduction velocity (CV) dynamics
Main finding
As reported in the abstract
ΔCV with pacing interval by voltage zone (CV restitution)
| Group | ΔCV PI1 (600-400 ms) | ΔCV PI2 (400-250 ms) | ΔCV PI1 | ΔCV PI2 |
|---|---|---|---|---|
| Non-LVZ | 0.03 ± 0.03 m/s | 0.54 ± 0.09 m/s | ||
| LVZ | 0.17 ± 0.09 m/s | 0.25 ± 0.11 m/s | ||
| Very LVZ | 0.03 ± 0.01 m/s | 0.04 ± 0.02 m/s |
ΔCV PI1 (600-400 ms)
Non-LVZ0.03 ± 0.03 m/s
LVZNot reported in the abstract
Very LVZNot reported in the abstract
ΔCV PI2 (400-250 ms)
Non-LVZ0.54 ± 0.09 m/s
LVZNot reported in the abstract
Very LVZNot reported in the abstract
ΔCV PI1
Non-LVZNot reported in the abstract
LVZ0.17 ± 0.09 m/s
Very LVZ0.03 ± 0.01 m/s
ΔCV PI2
Non-LVZNot reported in the abstract
LVZ0.25 ± 0.11 m/s
Very LVZ0.04 ± 0.02 m/s
- Rate-dependent CV (RDCV) slowing sites increase/patient, isoprenaline
- 2.7 ± 1.1
- RDCV slowing sites increase/patient, ganglionated plexi (GP) stimulation
- 2.8 ± 1.3
- Pivot points co-located to RDCV slowing sites
- 80.2%
- Pivot point increase/patient, isoprenaline
- 1.3 ± 1.1
- Pivot point increase/patient, GP stimulation
- 1.5 ± 1.1
Original publication
Autonomic modulation impacts conduction velocity dynamics and wavefront propagation in the left atrium. Europace. Published 4 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it