Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence

van der Does, Willemijn F. B.; Heida, Annejet; van der Does, Lisette J. M. E.; Bogers, Ad J. J. C.; de Groot, Natasja M. S.

doi:10.3390/jcm10132846

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Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence

Willemijn F. B. van der Does

¹,

Annejet Heida

¹,

Lisette J. M. E. van der Does

¹,

Ad J. J. C. Bogers

and

Natasja M. S. de Groot

^1,*

Department of Cardiology, Erasmus Medical Center, 3015 CN Rotterdam, The Netherlands

Department of Cardiothoracic Surgery, Erasmus Medical Center, 3015 CN Rotterdam, The Netherlands

Author to whom correspondence should be addressed.

Academic Editors: Gregory Y. H. Lip and Inna P. Gladysheva

J. Clin. Med. 2021, 10(13), 2846; https://doi.org/10.3390/jcm10132846

Received: 21 April 2021 / Revised: 25 May 2021 / Accepted: 24 June 2021 / Published: 27 June 2021

(This article belongs to the Section Cardiology)

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Abstract

Classification of atrial fibrillation (AF) is currently based on clinical characteristics. However, classifying AF using an objective electrophysiological parameter would be more desirable. The aim of this study was to quantify parameters of atrial conduction during sinus rhythm (SR) using an intra-operative high-resolution epicardial mapping approach and to relate these parameters to clinical classifications of AF. Patients were divided according to the standard clinical classification and spontaneous termination of AF episodes. The HATCH score, a score predictive of AF progression, was calculated, and surface ECGs were evaluated for signs of interatrial block. Conduction disorders mainly differed at Bachmann’s bundle (BB). Activation time (AT) at BB was longer in persistent AF patients (AT-BB: 75 (53–92) ms vs. 55 (40–76) ms, p = 0.017), patients without spontaneous termination of AF episodes (AT-BB: 53.5 (39.6–75.8) ms vs. 72.0 (49.6–80.8) ms, p = 0.009) and in patients with a P-wave duration ≥ 120 ms (64.3 (52.3–93.0) ms vs. 50.5 (39.6–56.6) ms, p = 0.014). HATCH scores also correlated positively to AT-BB (rho 0.326, p = 0.029). However, discriminatory values of electrophysiological parameters, as calculated using ROC-curves, were limited. These results may reflect shortcomings of clinical classifications and further research is needed to establish an objective substrate-based classification of AF. View Full-Text

Keywords: atrial fibrillation; conduction disturbances; high-resolution mapping; AF persistence

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MDPI and ACS Style

van der Does, W.F.B.; Heida, A.; van der Does, L.J.M.E.; Bogers, A.J.J.C.; de Groot, N.M.S. Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence. J. Clin. Med. 2021, 10, 2846. https://doi.org/10.3390/jcm10132846

AMA Style

van der Does WFB, Heida A, van der Does LJME, Bogers AJJC, de Groot NMS. Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence. Journal of Clinical Medicine. 2021; 10(13):2846. https://doi.org/10.3390/jcm10132846

Chicago/Turabian Style

van der Does, Willemijn F.B., Annejet Heida, Lisette J.M.E. van der Does, Ad J.J.C. Bogers, and Natasja M.S. de Groot. 2021. "Conduction Disorders during Sinus Rhythm in Relation to Atrial Fibrillation Persistence" Journal of Clinical Medicine 10, no. 13: 2846. https://doi.org/10.3390/jcm10132846

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