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The Effects of Valvular Heart Disease on Atrial Conduction During Sinus Rhythm.

Authors
  • van der Does, Lisette J M E1
  • Lanters, Eva A H1
  • Teuwen, Christophe P1
  • Mouws, Elisabeth M J P1, 2
  • Yaksh, Ameeta1
  • Knops, Paul1
  • Kik, Charles2
  • Bogers, Ad J J C2
  • de Groot, Natasja M S3
  • 1 Department of Cardiology, Erasmus Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. , (Netherlands)
  • 2 Department of Cardiothoracic Surgery, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands. , (Netherlands)
  • 3 Department of Cardiology, Erasmus Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. [email protected] , (Netherlands)
Type
Published Article
Journal
Journal of cardiovascular translational research
Publication Date
Aug 01, 2020
Volume
13
Issue
4
Pages
632–639
Identifiers
DOI: 10.1007/s12265-019-09936-8
PMID: 31773460
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Different arrhythmogenic substrates for atrial fibrillation (AF) may underlie aortic valve (AV) and mitral valve (MV) disease. We located conduction disorders during sinus rhythm by high-resolution epicardial mapping in patients undergoing AV (n = 85) or MV (n = 54) surgery. Extent and distribution of conduction delay (CD) and block (CD) across the entire right and left atrial surface was determined from circa 1880 unipolar electrogram recordings per patient. CD and CB were most pronounced at the superior intercaval area (2.5% of surface, maximal degree 6.6%/cm2). MV patients had a higher maximal degree of CD at the lateral left atrium than AV patients (4.2 vs 2.3%/cm2, p = 0.001). A history of AF was most strongly correlated to CD/CB at Bachmann's bundle and age. Although MV patients have more conduction disorders at the lateral left atrium, disturbed conduction at Bachmann's bundle during sinus rhythm indicates the presence of atrial remodeling which is related to AF episodes.

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