Arrhythmias & electrophysiologyMechanistic study
Autonomic modulation impacts conduction velocity dynamics and wavefront propagation in the left atrium
- Mechanistic study
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 |
- 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:10.1093/europace/euae219
Summarised from the published abstract; every number is checked against it