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Am J Physiol Heart Circ Physiol (July 28, 2006). doi:10.1152/ajpheart.01128.2005
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Submitted on October 24, 2005
Accepted on July 28, 2006

Structural Atrial Remodeling Alters the Substrate and Spatiotemporal Organization of AF: A Comparison in Canine Models of Structural and Electrical Atrial Remodeling

Thomas H Everett1, Emily E Wilson1, Sander Verheule2, Jose M Guerra1, Scott Foreman2, and Jeffrey Olgin1*

1 Division of Cardiology and the Cardiovascular Research Institute, University of California San Francisco, San Francisco, California, United States
2 Krannert Inst. of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, United States

* To whom correspondence should be addressed. E-mail: olgin{at}medicine.ucsf.edu.

Several animal models of atrial fibrillation (AF) have been developed that demonstrate either atrial structural remodeling or atrial electrical remodeling, but the characteristics and the spatiotemporal organization of the AF between the models has not been compared. Thirty-nine dogs were divided into 5 groups: rapid atrial pacing (RAP), chronic mitral regurgitation (MR), congestive heart failure (CHF), methylcholine (METH), and control. The right and left atria were simultaneously mapped during episodes of AF in each animal using high-density (240 electrodes) epicardial arrays. Multiple 30-second AF epochs were recorded in each dog. Fast Fourier-Transform (FFT) was calculated every 1-second over a sliding 2-second window and the dominant frequency (DF) was determined. Stable, discrete high-frequency areas were seen in none of the RAP or control dogs, 4 of 9 MR dogs, 4 of 6 CHF dogs, and 7 of 9 METH dogs in either the RA or LA or both. The average DFs in the METH model were significantly greater than all of the other models in both the LA and RA except the LA DFs in the RAP model. The RAP model was the only one with a consistent LA to RA DF gradient (9.5±0.2 Hz vs 8.3±0.3 Hz, p<0.00005). The METH model had a higher spatial and temporal variance of DFs, lower measured organization levels as compared to the other AF models, and it was the only model to show a linear relationship between the highest DF and the dispersion (R2 = 0.86). These data indicate that the structurally remodeled atria (models known to have predominantly altered conduction) leads to an AF characterized by a stable high-frequency area while the electrically remodeled atria (models known to have predominantly shortened refractoriness without significant conduction abnormalities) leads to an AF characterized by multiple high-frequency areas and multiple wavelets.




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