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* To whom correspondence should be addressed. E-mail: schotten{at}fys.unimaas.nl.
Atrial fibrillation (AF) induces a progressive dilatation of the atria which in turn might promote the arrhythmia. The mechanism of atrial dilatation during AF is not known. To test the hypothesis that loss of atrial contractile function is a primary cause of atrial dilatation during the first days of AF, 8 goats were chronically instrumented with epicardial electrodes, a pressure transducer in the right atrium and piezoelectric crystals to measure right atrial diameter. AF was induced by repetitive burst pacing. Atrial contractility was assessed during sinus rhythm, atrial pacing (160, 300, and 400ms cycle length) and electrically induced AF. The compliance of the fibrillating right atrium was measured during unloading the atria with diuretics and loading with 1L of saline. All measurements were repeated after 6, 12, and 24h of AF and then once a day during the first 5 days of AF. Recovery of the observed changes after spontaneous cardioversion was also studied. After 5 days of AF atrial contractility during sinus rhythm or slow atrial pacing was greatly reduced. During rapid pacing (160ms) or AF, the amplitude of the atrial pressure waves had declined to 20% of control. The compliance of the fibrillating atria increased 2-fold, whereas the right atrial pressure was unchanged. As a result, the mean right atrial diameter increased by ~12%. All changes were reversible within 3 days of sinus rhythm. We conclude that atrial dilatation during the first days of AF is due to an increase in atrial compliance caused by loss of atrial contractility during AF. Atrial compliance and size are restored when atrial contractility recovers following cardioversion of AF.
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