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Am J Physiol Heart Circ Physiol (August 22, 2002). doi:10.1152/ajpheart.00571.2002
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Articles in PresS, published online ahead of print August 22, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00571.2002
Submitted on July 12, 2002
Accepted on August 19, 2002

Slow Rate During AF Improves Ventricular Performance By Reducing Sensitivity to Cycle Length Irregularity

Zoran B Popovic1, Kent A Mowrey1, Youhua Zhang1, Shaowei Zhuang1, Tomotsugu Tabata1, Don W Wallick1, Richard A Grimm1, James D Thomas1, and Todor N Mazgalev1*

1 Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

* To whom correspondence should be addressed. E-mail: mazgalt{at}ccf.org.

Atrial fibrillation (AF) is characterized by short and irregular ventricular cycle lengths (VCL). While the beneficial effects of heart rate slowing (i.e., the prolongation of VCL) in AF are well recognized, little is known about the impact of irregularity. In 10 anesthetized dogs, RR intervals, left ventricular (LV) pressure, and aortic flow were collected for more than 500 beats during fast AF, and when the average VCL was prolonged to 75%, 100%, and 125% of the intrinsic sinus cycle length by selective atrioventricular (AV)-nodal vagal stimulation. We used the ratio of 2 consecutive RR intervals (RRp/RRpp) as an index of cycle length irregularity and assessed its effects on the maximum LV Power, dP/dtmin, and the time constant of relaxation ({tau}) by using nonlinear fitting with monoexponential functions. During prolongation of VCL there was a pronounced decrease in curvature with the formation of a plateau indicating lesser dependence on RRp/RRpp. We conclude that prolongation of the VCL during AF reduces the sensitivity of the LV performance parameters to irregularity.




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