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 · 2013
Prevalence and electrophysiological characteristics of typical atrial flutter in patients with atrial fibrillation and chronic obstructive pulmonary disease.
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Hayashi Takekuni, Fukamizu Seiji, Hojo Rintaro, Komiyama Kota, Tanabe Yasuhiro, Tejima Tamotsu, Nishizaki Mitsuhiro, Hiraoka Masayasu, Ako Junya, Momomura Shin-Ichi, Sakurada Harumizu
Аннотация
AIMS: Chronic obstructive pulmonary disease (COPD) is one of the important underlying diseases of atrial fibrillation (AF). However, the prevalence and electrophysiological characteristics of typical atrial flutter (AFL) in patients with AF and COPD remain unknown. The purpose of the present study was to investigate those characteristics.
METHODS AND RESULTS: We investigated 181 consecutive patients who underwent catheter ablation of AF. Twenty-eight patients were diagnosed with COPD according to the Global Initiatives for Chronic Obstructive Lung Disease (GOLD) criteria. Forty patients with no lung disease served as a control group. We analysed the electrophysiological characteristics in these groups. Typical AFL was more common in the COPD group (19/28, 68%) than in the non-COPD group (13/40, 33%; P = 0.006). The prevalence of AFL increased with the severity of COPD: 4 (50%) of 8 patients with GOLD1, 13 (72%) of 18 patients with GOLD2, and 2 (100%) of 2 patients with GOLD3. Atrial flutter cycle length and conduction time from the coronary sinus (CS) ostium to the low lateral right atrium (RA) during CS ostium pacing before and after the cavotricuspid isthmus ablation were significantly longer in the COPD group than in the non-COPD group (285 vs. 236, 71 vs. 53, 164 vs. 134 ms; P = 0.009, 0.03, 0.002, respectively).
CONCLUSION: In COPD patients with AF, conduction time of RA was prolonged and typical AFL was commonly observed.
METHODS AND RESULTS: We investigated 181 consecutive patients who underwent catheter ablation of AF. Twenty-eight patients were diagnosed with COPD according to the Global Initiatives for Chronic Obstructive Lung Disease (GOLD) criteria. Forty patients with no lung disease served as a control group. We analysed the electrophysiological characteristics in these groups. Typical AFL was more common in the COPD group (19/28, 68%) than in the non-COPD group (13/40, 33%; P = 0.006). The prevalence of AFL increased with the severity of COPD: 4 (50%) of 8 patients with GOLD1, 13 (72%) of 18 patients with GOLD2, and 2 (100%) of 2 patients with GOLD3. Atrial flutter cycle length and conduction time from the coronary sinus (CS) ostium to the low lateral right atrium (RA) during CS ostium pacing before and after the cavotricuspid isthmus ablation were significantly longer in the COPD group than in the non-COPD group (285 vs. 236, 71 vs. 53, 164 vs. 134 ms; P = 0.009, 0.03, 0.002, respectively).
CONCLUSION: In COPD patients with AF, conduction time of RA was prolonged and typical AFL was commonly observed.
Предметные рубрики MeSH
AgedAtrial FibrillationAtrial FlutterAtrial Function, RightCase-Control StudiesCatheter AblationDisease-Free SurvivalElectrophysiologic Techniques, CardiacFemaleHeart AtriaHumansJapanKaplan-Meier EstimateMaleMiddle AgedPredictive Value of TestsPrevalencePulmonary Disease, Chronic ObstructivePulmonary VeinsRecurrenceSeverity of Illness IndexTime FactorsTreatment Outcome