Spatial distribution of conduction disorders during sinus rhythm

Eva A.H. Lanters, Ameeta Yaksh, Christophe P. Teuwen, Lisette J.M.E. van der Does, Charles Kik, Paul Knops, Denise M.S. van Marion, Bianca J.J.M. Brundel, Ad J.J.C. Bogers, Maurits A. Allessie, Natasja M.S. de Groot

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Length of lines of conduction block (CB) during sinus rhythm (SR) at Bachmann's bundle (BB) is associated with atrial fibrillation (AF). However, it is unknown whether extensiveness of CB at BB represents CB elsewhere in the atria. We aim to investigate during SR 1) the spatial distribution and extensiveness of CB 2) whether there is a predilection site for CB and 3) the association between CB and incidence of post-operative AF. Methods During SR, epicardial mapping of the right atrium (RA), BB and left atrium was performed in 209 patients with coronary artery disease. The amount of conduction delay (CD, Δlocal activation time ≥ 7 ms) and CB (Δ ≥ 12 ms) was quantified as % of the mapping area. Atrial regions were compared to identify potential predilection sites for CD/CB. Correlations between CD/CB and clinical characteristics were tested. Results Areas with CD or CB were present in all patients, overall prevalence was respectively 1.4(0.2–4.0) % and 1.3(0.1–4.3) %. Extensiveness and spatial distribution of CD/CB varied considerably, however occurred mainly at the superior intercaval RA. Of all clinicalcharacteristics, CD/CB only correlated weakly with age and diabetes (P < 0.05). A 1% increase in CD or CB caused a 1.1–1.5ms prolongation of the activation time (P < 0.001). There was no correlation between CD/CB and post-operative AF. Conclusion CD/CB during SR in CABG patients with electrically non-remodeled atria show considerable intra-atrial, but also inter-individual variation. Despite these differences, a predilection site is present at the superior intercaval RA. Extensiveness of CB at the superior intercaval RA or BB does not reflect CB elsewhere in the atria and is not associated with post-operative AF.

Original languageEnglish
Pages (from-to)220-225
Number of pages6
JournalInternational Journal of Cardiology
Volume249
DOIs
Publication statusPublished - 15 Dec 2017

Cite this

Lanters, E. A. H., Yaksh, A., Teuwen, C. P., van der Does, L. J. M. E., Kik, C., Knops, P., ... de Groot, N. M. S. (2017). Spatial distribution of conduction disorders during sinus rhythm. International Journal of Cardiology, 249, 220-225. https://doi.org/10.1016/j.ijcard.2017.08.067
Lanters, Eva A.H. ; Yaksh, Ameeta ; Teuwen, Christophe P. ; van der Does, Lisette J.M.E. ; Kik, Charles ; Knops, Paul ; van Marion, Denise M.S. ; Brundel, Bianca J.J.M. ; Bogers, Ad J.J.C. ; Allessie, Maurits A. ; de Groot, Natasja M.S. / Spatial distribution of conduction disorders during sinus rhythm. In: International Journal of Cardiology. 2017 ; Vol. 249. pp. 220-225.
@article{3a052f3e8602436db65e241087c5915a,
title = "Spatial distribution of conduction disorders during sinus rhythm",
abstract = "Background Length of lines of conduction block (CB) during sinus rhythm (SR) at Bachmann's bundle (BB) is associated with atrial fibrillation (AF). However, it is unknown whether extensiveness of CB at BB represents CB elsewhere in the atria. We aim to investigate during SR 1) the spatial distribution and extensiveness of CB 2) whether there is a predilection site for CB and 3) the association between CB and incidence of post-operative AF. Methods During SR, epicardial mapping of the right atrium (RA), BB and left atrium was performed in 209 patients with coronary artery disease. The amount of conduction delay (CD, Δlocal activation time ≥ 7 ms) and CB (Δ ≥ 12 ms) was quantified as {\%} of the mapping area. Atrial regions were compared to identify potential predilection sites for CD/CB. Correlations between CD/CB and clinical characteristics were tested. Results Areas with CD or CB were present in all patients, overall prevalence was respectively 1.4(0.2–4.0) {\%} and 1.3(0.1–4.3) {\%}. Extensiveness and spatial distribution of CD/CB varied considerably, however occurred mainly at the superior intercaval RA. Of all clinicalcharacteristics, CD/CB only correlated weakly with age and diabetes (P < 0.05). A 1{\%} increase in CD or CB caused a 1.1–1.5ms prolongation of the activation time (P < 0.001). There was no correlation between CD/CB and post-operative AF. Conclusion CD/CB during SR in CABG patients with electrically non-remodeled atria show considerable intra-atrial, but also inter-individual variation. Despite these differences, a predilection site is present at the superior intercaval RA. Extensiveness of CB at the superior intercaval RA or BB does not reflect CB elsewhere in the atria and is not associated with post-operative AF.",
keywords = "Conduction block, Conduction disorders, Coronary artery disease, Mapping, Sinus rhythm",
author = "Lanters, {Eva A.H.} and Ameeta Yaksh and Teuwen, {Christophe P.} and {van der Does}, {Lisette J.M.E.} and Charles Kik and Paul Knops and {van Marion}, {Denise M.S.} and Brundel, {Bianca J.J.M.} and Bogers, {Ad J.J.C.} and Allessie, {Maurits A.} and {de Groot}, {Natasja M.S.}",
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language = "English",
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pages = "220--225",
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Lanters, EAH, Yaksh, A, Teuwen, CP, van der Does, LJME, Kik, C, Knops, P, van Marion, DMS, Brundel, BJJM, Bogers, AJJC, Allessie, MA & de Groot, NMS 2017, 'Spatial distribution of conduction disorders during sinus rhythm' International Journal of Cardiology, vol. 249, pp. 220-225. https://doi.org/10.1016/j.ijcard.2017.08.067

Spatial distribution of conduction disorders during sinus rhythm. / Lanters, Eva A.H.; Yaksh, Ameeta; Teuwen, Christophe P.; van der Does, Lisette J.M.E.; Kik, Charles; Knops, Paul; van Marion, Denise M.S.; Brundel, Bianca J.J.M.; Bogers, Ad J.J.C.; Allessie, Maurits A.; de Groot, Natasja M.S.

In: International Journal of Cardiology, Vol. 249, 15.12.2017, p. 220-225.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Spatial distribution of conduction disorders during sinus rhythm

AU - Lanters, Eva A.H.

AU - Yaksh, Ameeta

AU - Teuwen, Christophe P.

AU - van der Does, Lisette J.M.E.

AU - Kik, Charles

AU - Knops, Paul

AU - van Marion, Denise M.S.

AU - Brundel, Bianca J.J.M.

AU - Bogers, Ad J.J.C.

AU - Allessie, Maurits A.

AU - de Groot, Natasja M.S.

PY - 2017/12/15

Y1 - 2017/12/15

N2 - Background Length of lines of conduction block (CB) during sinus rhythm (SR) at Bachmann's bundle (BB) is associated with atrial fibrillation (AF). However, it is unknown whether extensiveness of CB at BB represents CB elsewhere in the atria. We aim to investigate during SR 1) the spatial distribution and extensiveness of CB 2) whether there is a predilection site for CB and 3) the association between CB and incidence of post-operative AF. Methods During SR, epicardial mapping of the right atrium (RA), BB and left atrium was performed in 209 patients with coronary artery disease. The amount of conduction delay (CD, Δlocal activation time ≥ 7 ms) and CB (Δ ≥ 12 ms) was quantified as % of the mapping area. Atrial regions were compared to identify potential predilection sites for CD/CB. Correlations between CD/CB and clinical characteristics were tested. Results Areas with CD or CB were present in all patients, overall prevalence was respectively 1.4(0.2–4.0) % and 1.3(0.1–4.3) %. Extensiveness and spatial distribution of CD/CB varied considerably, however occurred mainly at the superior intercaval RA. Of all clinicalcharacteristics, CD/CB only correlated weakly with age and diabetes (P < 0.05). A 1% increase in CD or CB caused a 1.1–1.5ms prolongation of the activation time (P < 0.001). There was no correlation between CD/CB and post-operative AF. Conclusion CD/CB during SR in CABG patients with electrically non-remodeled atria show considerable intra-atrial, but also inter-individual variation. Despite these differences, a predilection site is present at the superior intercaval RA. Extensiveness of CB at the superior intercaval RA or BB does not reflect CB elsewhere in the atria and is not associated with post-operative AF.

AB - Background Length of lines of conduction block (CB) during sinus rhythm (SR) at Bachmann's bundle (BB) is associated with atrial fibrillation (AF). However, it is unknown whether extensiveness of CB at BB represents CB elsewhere in the atria. We aim to investigate during SR 1) the spatial distribution and extensiveness of CB 2) whether there is a predilection site for CB and 3) the association between CB and incidence of post-operative AF. Methods During SR, epicardial mapping of the right atrium (RA), BB and left atrium was performed in 209 patients with coronary artery disease. The amount of conduction delay (CD, Δlocal activation time ≥ 7 ms) and CB (Δ ≥ 12 ms) was quantified as % of the mapping area. Atrial regions were compared to identify potential predilection sites for CD/CB. Correlations between CD/CB and clinical characteristics were tested. Results Areas with CD or CB were present in all patients, overall prevalence was respectively 1.4(0.2–4.0) % and 1.3(0.1–4.3) %. Extensiveness and spatial distribution of CD/CB varied considerably, however occurred mainly at the superior intercaval RA. Of all clinicalcharacteristics, CD/CB only correlated weakly with age and diabetes (P < 0.05). A 1% increase in CD or CB caused a 1.1–1.5ms prolongation of the activation time (P < 0.001). There was no correlation between CD/CB and post-operative AF. Conclusion CD/CB during SR in CABG patients with electrically non-remodeled atria show considerable intra-atrial, but also inter-individual variation. Despite these differences, a predilection site is present at the superior intercaval RA. Extensiveness of CB at the superior intercaval RA or BB does not reflect CB elsewhere in the atria and is not associated with post-operative AF.

KW - Conduction block

KW - Conduction disorders

KW - Coronary artery disease

KW - Mapping

KW - Sinus rhythm

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U2 - 10.1016/j.ijcard.2017.08.067

DO - 10.1016/j.ijcard.2017.08.067

M3 - Article

VL - 249

SP - 220

EP - 225

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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Lanters EAH, Yaksh A, Teuwen CP, van der Does LJME, Kik C, Knops P et al. Spatial distribution of conduction disorders during sinus rhythm. International Journal of Cardiology. 2017 Dec 15;249:220-225. https://doi.org/10.1016/j.ijcard.2017.08.067