Length of excitation wave and susceptibility to reentrant atrial arrhythmias in normal conscious dogs

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Circulation Research. 1988;62:395-410

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ARTICLES

Length of excitation wave and susceptibility to reentrant atrial arrhythmias in normal conscious dogs

PL Rensma, MA Allessie, WJ Lammers, FI Bonke and MJ Schalij
Department of Physiology, University of Limburg, Maastricht, The Netherlands.

We calculated the wavelength of the atrial impulse in chronically instrumented conscious dogs by measuring both conduction velocity and refractory period: wavelength = refractory period X conduction velocity. Implantation of multiple stimulating and recording electrodes allowed wavelength determination at four different areas: the right and left parts of Bachmann's bundle and the free walls of the right and left atria. During programmed electrical stimulation, three types of arrhythmias were observed: rapid repetitive responses, atrial flutter, and atrial fibrillation. During normal rhythm, the wavelength of the atrial impulse varied between 14 and 18 cm. Premature beats had a shorter wavelength, depending on the degree of prematurity. Premature beats that evoked rapid repetitive responses showed a critical shortening of the wavelength below 12.3 cm. Episodes of atrial flutter were induced at a wavelength below 9.7 cm, while fibrillation occurred at wavelengths shorter than 7.8 cm. We correlated the induction of these arrhythmias with the values of refractory period, conduction velocity, and wavelength during control and during administration of several drugs. Intravenous administration of acetylcholine shortened the wavelength by 30-40%, mainly because of refractory period shortening. Both propafenone and lidocaine had strong but opposite effects on refractoriness and conduction and, consequently, little effect on the wavelength. Quinidine markedly prolonged the refractory period, but prolongation of wavelength was less because of a simultaneous decrease in conduction velocity. d-Sotalol also increased refractory period, but because it had no appreciable effect on conduction velocity, this drug was the most effective in prolongation of wavelength. Linear discriminant analysis of the data showed that the refractory period and the conduction velocity each were poor parameters to predict the occurrence of the different arrhythmias (predictive value 48% and 38%, respectively). The combination of both properties, however, as expressed in the wavelength, was a more reliable index that predicted the induction of the different arrhythmias correctly in 75% of the cases. We conclude that the wavelength is a useful parameter for evaluating antiarrhythmic drugs.

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[Abstract] [PDF]

C. Pandozi, L. Bianconi, M. Villani, G. Gentilucci, A. Castro, G. Altamura, A. P. Jesi, F. Lamberti, F. Ammirati, and M. Santini
Electrophysiological Characteristics of the Human Atria After Cardioversion of Persistent Atrial Fibrillation
Circulation, December 22, 1998; 98(25): 2860 - 2865.
[Abstract] [Full Text] [PDF]

J. E. Olgin, H. J. Sih, S. Hanish, J. V. Jayachandran, J. Wu, Q. H. Zheng, W. Winkle, G. K. Mulholland, D. P. Zipes, and G. Hutchins
Heterogeneous Atrial Denervation Creates Substrate for Sustained Atrial Fibrillation
Circulation, December 8, 1998; 98(23): 2608 - 2614.
[Abstract] [Full Text] [PDF]

S. Fareh, C. Villemaire, and S. Nattel
Importance of Refractoriness Heterogeneity in the Enhanced Vulnerability to Atrial Fibrillation Induction Caused by Tachycardia-Induced Atrial Electrical Remodeling
Circulation, November 17, 1998; 98(20): 2202 - 2209.
[Abstract] [Full Text] [PDF]

J. Feng, D. Xu, Z. Wang, and S. Nattel
Ultrarapid delayed rectifier current inactivation in human atrial myocytes: properties and consequences
Am J Physiol Heart Circ Physiol, November 1, 1998; 275(5): H1717 - H1725.
[Abstract] [Full Text] [PDF]

T. L. Riemer, E. A. Sobie, and L. Tung
Stretch-induced changes in arrhythmogenesis and excitability in experimentally based heart cell models
Am J Physiol Heart Circ Physiol, August 1, 1998; 275(2): H431 - H442.
[Abstract] [Full Text] [PDF]

F. L Burton and S. M Cobbe
Effect of sustained stretch on dispersion of ventricular fibrillation intervals in normal rabbit hearts
Cardiovasc Res, August 1, 1998; 39(2): 351 - 359.
[Abstract] [Full Text] [PDF]

M P Ingemansson, M Holm, and S B Olsson
Autonomic modulation of the atrial cycle length by the head up tilt test: non-invasive evaluation in patients with chronic atrial fibrillation
Heart, July 1, 1998; 80(1): 71 - 76.
[Abstract] [Full Text]

P. F. Kirchhof, C. L. Fabritz, and M. R. Franz
Postrepolarization Refractoriness Versus Conduction Slowing Caused by Class I Antiarrhythmic Drugs : Antiarrhythmic and Proarrhythmic Effects
Circulation, June 30, 1998; 97(25): 2567 - 2574.
[Abstract] [Full Text] [PDF]

W.-C. Yu, S.-A. Chen, S.-H. Lee, C.-T. Tai, A.-N. Feng, B. I.-T. Kuo, Y.-A. Ding, and M.-S. Chang
Tachycardia-Induced Change of Atrial Refractory Period in Humans : Rate Dependency and Effects of Antiarrhythmic Drugs
Circulation, June 16, 1998; 97(23): 2331 - 2337.
[Abstract] [Full Text] [PDF]

M A Vos, S R Golitsyn, K Stangl, M Y Ruda, L Van Wijk, J D Harry, K T Perry, P Touboul, G Steinbeck, and H J J Wellens
Superiority of ibutilide (a new class III agent) over DL-sotalol in converting atrial flutter and atrial fibrillation
Heart, June 1, 1998; 79(6): 568 - 575.
[Abstract] [Full Text]

Y. Y. Kwan, W. Fan, D. Hough, J. J. Lee, M. C. Fishbein, H. S. Karagueuzian, and P.-S. Chen
Effects of Procainamide on Wave-Front Dynamics During Ventricular Fibrillation in Open-Chest Dogs
Circulation, May 12, 1998; 97(18): 1828 - 1836.
[Abstract] [Full Text] [PDF]

M. R. Ujhelyi, J. J. Sims, and A. W. Miller
High-dose lidocaine does not affect defibrillation efficacy: implications for defibrillation mechanisms
Am J Physiol Heart Circ Physiol, April 1, 1998; 274(4): H1113 - H1120.
[Abstract] [Full Text] [PDF]

M. Holm, S. Pehrson, M. Ingemansson, L. Sornmo, R. Johansson, L. Sandhall, M. Sunemark, B. Smideberg, C. Olsson, and S.B. Olsson
Non-invasive assessment of the atrial cycle length during atrial fibrillation in man: introducing, validating and illustrating a new ECG method
Cardiovasc Res, April 1, 1998; 38(1): 69 - 81.
[Abstract] [Full Text] [PDF]

J. Kobayashi, Y. Kosakai, K. Nakano, Y. Sasako, K. Eishi, and F. Yamamoto
Improved success rate of the maze procedure in mitral valve disease by new criteria for patients' selection
Eur. J. Cardiothorac. Surg., March 1, 1998; 13(3): 247 - 252.
[Abstract] [Full Text] [PDF]

S. Nattel, L. Liu, and D. St-Georges
Effects of the novel antiarrhythmic agent azimilide on experimental atrial fibrillation and atrial electrophysiologic properties
Cardiovasc Res, March 1, 1998; 37(3): 627 - 635.
[Abstract] [Full Text] [PDF]

N. S. Peters, J. Coromilas, M. S. Hanna, M. E. Josephson, C. Costeas, and A. L. Wit
Characteristics of the Temporal and Spatial Excitable Gap in Anisotropic Reentrant Circuits Causing Sustained Ventricular Tachycardia
Circ. Res., February 9, 1998; 82(2): 279 - 293.
[Abstract] [Full Text] [PDF]

R. Gaspo, R. F. Bosch, E. Bou-Abboud, and S. Nattel
Tachycardia-Induced Changes in Na+ Current in a Chronic Dog Model of Atrial Fibrillation
Circ. Res., December 19, 1997; 81(6): 1045 - 1052.
[Abstract] [Full Text]

B. S. Stambler, M. A. Wood, and K. A. Ellenbogen
Antiarrhythmic Actions of Intravenous Ibutilide Compared With Procainamide During Human Atrial Flutter and Fibrillation : Electrophysiological Determinants of Enhanced Conversion Efficacy
Circulation, December 16, 1997; 96(12): 4298 - 4306.
[Abstract] [Full Text]

R. Gaspo, R. F. Bosch, M. Talajic, and S. Nattel
Functional Mechanisms Underlying Tachycardia-Induced Sustained Atrial Fibrillation in a Chronic Dog Model
Circulation, December 2, 1997; 96(11): 4027 - 4035.
[Abstract] [Full Text]

M. J. Reiter, M. Landers, Z. Zetelaki, C. J. H. Kirchhof, and M. A. Allessie
Electrophysiological Effects of Acute Dilatation in the Isolated Rabbit Heart : Cycle Length�Dependent Effects on Ventricular Refractoriness and Conduction Velocity
Circulation, December 2, 1997; 96(11): 4050 - 4056.
[Abstract] [Full Text]

M. C. E. F. Wijffels, C. J. H. J. Kirchhof, R. Dorland, J. Power, and M. A. Allessie
Electrical Remodeling due to Atrial Fibrillation in Chronically Instrumented Conscious Goats : Roles of Neurohumoral Changes, Ischemia, Atrial Stretch, and High Rate of Electrical Activation
Circulation, November 18, 1997; 96(10): 3710 - 3720.
[Abstract] [Full Text]

C.-T. Tai, S.-A. Chen, C.-E. Chiang, S.-H. Lee, K.-C. Ueng, Z.-C. Wen, J.-L. Huang, Y.-J. Chen, W.-C. Yu, A.-N. Feng, et al.
Characterization of Low Right Atrial Isthmus as the Slow Conduction Zone and Pharmacological Target in Typical Atrial Flutter
Circulation, October 21, 1997; 96(8): 2601 - 2611.
[Abstract] [Full Text]

E. G. Daoud, B. P. Knight, R. Weiss, M. Bahu, W. Paladino, R. Goyal, K. C. Man, S. A. Strickberger, and F. Morady
Effect of Verapamil and Procainamide on Atrial Fibrillation�Induced Electrical Remodeling in Humans
Circulation, September 2, 1997; 96(5): 1542 - 1550.
[Abstract] [Full Text]

R. G. Tieleman, C. D. J. De Langen, I. C. Van Gelder, P. J. de Kam, J. Grandjean, K. J. Bel, M. C. E. F. Wijffels, M. A. Allessie, and H. J. G. M. Crijns
Verapamil Reduces Tachycardia-Induced Electrical Remodeling of the Atria
Circulation, April 1, 1997; 95(7): 1945 - 1953.
[Abstract] [Full Text]

				C. E.B. Balbao, A. A.V. de Paola, and G. Fenelon Effects of alcohol on atrial fibrillation: myths and truths Therapeutic Advances in Cardiovascular Disease, February 1, 2009; 3(1): 53 - 63. [Abstract] [PDF]

				P. Comtois, M. Sakabe, E. J. Vigmond, M. Munoz, A. Texier, A. Shiroshita-Takeshita, and S. Nattel Mechanisms of atrial fibrillation termination by rapidly unbinding Na+ channel blockers: insights from mathematical models and experimental correlates Am J Physiol Heart Circ Physiol, October 1, 2008; 295(4): H1489 - H1504. [Abstract] [Full Text] [PDF]

				C.-T. Tsai, L.-P. Lai, J.-J. Hwang, J.-L. Lin, and F.-T. Chiang Molecular Genetics of Atrial Fibrillation J. Am. Coll. Cardiol., July 22, 2008; 52(4): 241 - 250. [Abstract] [Full Text] [PDF]

				J. W. Cheng Vernakalant in the Management of Atrial Fibrillation Ann. Pharmacother., April 1, 2008; 42(4): 533 - 542. [Abstract] [Full Text] [PDF]

				H. Watanabe, N. Tanabe, T. Watanabe, D. Darbar, D. M. Roden, S. Sasaki, and Y. Aizawa Metabolic Syndrome and Risk of Development of Atrial Fibrillation: The Niigata Preventive Medicine Study Circulation, March 11, 2008; 117(10): 1255 - 1260. [Abstract] [Full Text] [PDF]

				C R Liu, L Y Li, F Shi, X Y Zang, Y M Liu, Y Sun, and B H Kan Effects of hyper- and hypothyroid on expression of thyroid hormone receptor mRNA in rat myocardium J. Endocrinol., December 1, 2007; 195(3): 429 - 438. [Abstract] [Full Text] [PDF]

				G. Smith Matters of the heart: the physiology of cardiac function and failure Exp Physiol, November 1, 2007; 92(6): 973 - 986. [Abstract] [Full Text] [PDF]

				P. Lukac, V. E. Hjortdal, A. K. Pedersen, P. T. Mortensen, H. K. Jensen, and P. S. Hansen Prevention of Atrial Flutter With Cryoablation May Be Proarrhythmogenic Ann. Thorac. Surg., May 1, 2007; 83(5): 1717 - 1723. [Abstract] [Full Text] [PDF]

				R. J. Shemin, J. L. Cox, A. M. Gillinov, E. H. Blackstone, and C. R. Bridges Guidelines for Reporting Data and Outcomes for the Surgical Treatment of Atrial Fibrillation Ann. Thorac. Surg., March 1, 2007; 83(3): 1225 - 1230. [Abstract] [Full Text] [PDF]

				A. Bauer, R. Becker, J. Dreyhaupt, F. Voss, P. Kraft, K. Kelemen, J. C. Senges-Becker, H. A. Katus, and W. Schoels Role of KATP channels in repetitive induction of ventricular fibrillation Europace, March 1, 2007; 9(3): 154 - 161. [Abstract] [Full Text] [PDF]

				I. C. Van Gelder and M. E.W. Hemels The progressive nature of atrial fibrillation: a rationale for early restoration and maintenance of sinus rhythm Europace, November 1, 2006; 8(11): 943 - 949. [Abstract] [Full Text] [PDF]

				Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 651 - 745. [Full Text] [PDF]

				V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): e149 - e246. [Full Text] [PDF]

				R. Ochi, Y. Momose, K. Oyama, and W. R. Giles Sphingosine-1-phosphate effects on guinea pig atrial myocytes: Alterations in action potentials and K+ currents Cardiovasc Res, April 1, 2006; 70(1): 88 - 96. [Abstract] [Full Text] [PDF]

				Y. Hu, S. V. P. Jones, and W. H. Dillmann Effects of hyperthyroidism on delayed rectifier K+ currents in left and right murine atria Am J Physiol Heart Circ Physiol, October 1, 2005; 289(4): H1448 - H1455. [Abstract] [Full Text] [PDF]

				I. R. Efimov and V. V. Fedorov Chessboard of atrial fibrillation: reentry or focus? Single or multiple source(s)? Neurogenic or myogenic? Am J Physiol Heart Circ Physiol, September 1, 2005; 289(3): H977 - H979. [Full Text] [PDF]

				R. Zou, J. Kneller, L. J. Leon, and S. Nattel Substrate size as a determinant of fibrillatory activity maintenance in a mathematical model of canine atrium Am J Physiol Heart Circ Physiol, September 1, 2005; 289(3): H1002 - H1012. [Abstract] [Full Text] [PDF]

				J. N. Weiss, Z. Qu, P.-S. Chen, S.-F. Lin, H. S. Karagueuzian, H. Hayashi, A. Garfinkel, and A. Karma The Dynamics of Cardiac Fibrillation Circulation, August 23, 2005; 112(8): 1232 - 1240. [Abstract] [Full Text] [PDF]

				A. C.P. Wiesfeld, M. E.W. Hemels, J. P. Van Tintelen, M. P. Van den Berg, D. J. Van Veldhuisen, and I. C. Van Gelder Genetic aspects of atrial fibrillation Cardiovasc Res, August 15, 2005; 67(3): 414 - 418. [Abstract] [Full Text] [PDF]

				F. Holmqvist, M. Stridh, J. E. P. Waktare, J. Brandt, L. Sornmo, A. Roijer, and C. J. Meurling Rapid fluctuations in atrial fibrillatory electrophysiology detected during controlled respiration Am J Physiol Heart Circ Physiol, August 1, 2005; 289(2): H754 - H760. [Abstract] [Full Text] [PDF]

				J. A. Vest, X. H.T. Wehrens, S. R. Reiken, S. E. Lehnart, D. Dobrev, P. Chandra, P. Danilo, U. Ravens, M. R. Rosen, and A. R. Marks Defective Cardiac Ryanodine Receptor Regulation During Atrial Fibrillation Circulation, April 26, 2005; 111(16): 2025 - 2032. [Abstract] [Full Text] [PDF]

				J. Kneller, J. Kalifa, R. Zou, A. V. Zaitsev, M. Warren, O. Berenfeld, E. J. Vigmond, L. J. Leon, S. Nattel, and J. Jalife Mechanisms of Atrial Fibrillation Termination by Pure Sodium Channel Blockade in an Ionically-Realistic Mathematical Model Circ. Res., March 18, 2005; 96(5): e35 - e47. [Abstract] [Full Text] [PDF]

				V. Jacquemet, N. Virag, and L. Kappenberger Wavelength and vulnerability to atrial fibrillation: Insights from a computer model of human atria Europace, January 1, 2005; 7(s2): S83 - S92. [Abstract] [Full Text] [PDF]

				G. D. Veenhuyzen, C. S. Simpson, and H. Abdollah Atrial fibrillation Can. Med. Assoc. J., September 28, 2004; 171(7): 755 - 760. [Abstract] [Full Text] [PDF]

				J. Reisinger, E. Gatterer, W. Lang, T. Vanicek, G. Eisserer, T. Bachleitner, C. Niemeth, F. Aicher, W. Grander, G. Heinze, et al. Flecainide versus ibutilide for immediate cardioversion of atrial fibrillation of recent onset Eur. Heart J., August 1, 2004; 25(15): 1318 - 1324. [Abstract] [Full Text] [PDF]

				M.-C. Chen, J.-P. Chang, and H.-W. Chang Preoperative Atrial Size Predicts the Success of Radiofrequency Maze Procedure for Permanent Atrial Fibrillation in Patients Undergoing Concomitant Valvular Surgery Chest, June 1, 2004; 125(6): 2129 - 2134. [Abstract] [Full Text] [PDF]

				A. G. KLEBER and Y. RUDY Basic Mechanisms of Cardiac Impulse Propagation and Associated Arrhythmias Physiol Rev, April 1, 2004; 84(2): 431 - 488. [Abstract] [Full Text] [PDF]

				A. E. Saltman New-onset postoperative atrial fibrillation: A riddle wrapped in a mystery inside an enigma J. Thorac. Cardiovasc. Surg., February 1, 2004; 127(2): 311 - 313. [Full Text] [PDF]

				P. Spurrell, K. Kamalvand, M. Higson, and N. Sulke Temporal changes in atrial refractoriness following DC cardioversion of persistent atrial fibrillation in man Europace, January 1, 2004; 6(3): 229 - 235. [Abstract] [Full Text] [PDF]

				H. Hayashi, C. Omichi, Y. Miyauchi, W. J. Mandel, S.-F. Lin, P.-S. Chen, and H. S. Karagueuzian Age-related sensitivity to nicotine for inducible atrial tachycardia and atrial fibrillation Am J Physiol Heart Circ Physiol, November 1, 2003; 285(5): H2091 - H2098. [Abstract] [Full Text] [PDF]