+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Atrial fibrillation inducibility in the absence of structural heart disease or clinical atrial fibrillation: critical dependence on induction protocol, inducibility definition, and number of inductions



Atrial fibrillation inducibility in the absence of structural heart disease or clinical atrial fibrillation: critical dependence on induction protocol, inducibility definition, and number of inductions



Circulation. Arrhythmia and Electrophysiology 5(3): 531-536



Inducibility of atrial fibrillation (AF) after pulmonary vein isolation has been used to guide additional left atrial ablation in paroxysmal AF. The sensitivity and specificity of AF induction in this setting remains uncertain. We examined the incidence and characteristics of inducible AF in patients without structural heart disease or clinical AF and the effect of different induction protocols on AF inducibility. In 44 patients with supraventricular tachycardia with no history of AF or risk factors for AF, atrial refractoriness and conduction were measured, followed by AF induction attempts (10/patient). Each induction was performed after a waiting time that exceeded twice the duration of induced AF from the preceding induction. AF≥1 minute was considered inducible, and ≥5 minutes as sustained. Burst pacing (at 200 ms for 10 seconds) was compared to decremental pacing (from 200 ms to shortest cycle length, resulting in 1:1 atrial capture for 10 seconds). After 10 inductions, AF was inducible in 49.5%, and sustained in 29.5% of patients. The incidence of both inducible and sustained AF increased with each induction. Apart from male gender, no clinical or electrophysiological features were associated with sustained AF. Decremental pacing was associated with a higher incidence of sustained AF (41.2% versus 14.8%, P=0.049), longer duration of AF (P=0.006), and shorter mean AF cycle length (P<0.001) compared with burst pacing. Inducible and sustained AF is common in patients in the absence of structural heart disease or clinical AF, and its incidence varies according to gender, method of induction, and number of inductions. There is a direct relationship between AF persistence and number of inductions, which has not reached a plateau after 10 inductions.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 036460891

Download citation: RISBibTeXText

PMID: 22528047

DOI: 10.1161/CIRCEP.111.968859


Related references

Atrial fibrillation inducibility during cavotricuspid isthmus-dependent atrial flutter ablation as a predictor of clinical atrial fibrillation. A meta-analysis. Journal of Interventional Cardiac Electrophysiology 48(3): 307-315, 2017

Atrial fibrillation inducibility during cavo-tricuspid isthmus dependent atrial flutter ablation for the prediction of clinical atrial fibrillation. International Journal of Cardiology 240: 246-250, 2018

Lack of prognostic value of atrial arrhythmia inducibility and change in inducibility status after catheter ablation of atrial fibrillation. Heart Rhythm 15(5): 660-665, 2017

Evaluation of atrial refractoriness and atrial fibrillation inducibility immediately after internal cardioversion in patients with chronic persistent atrial fibrillation. Cardiovascular Drugs & Therapy 13(6): 507-511, 1999

Evaluation of atrial refractoriness and atrial fibrillation inducibility immediately after internal cardioversion in patients with chronic persistent atrial fibrillation. Cardiovascular Drugs and Therapy 13(6): 507-511, 2000

Prognostic Value of Atrial Fibrillation Inducibility in Patients Without History of Clinical Atrial Fibrillation. Journal of Atrial Fibrillation 11(1): 1837, 2018

Inducibility of atrial fibrillation in the absence of atrial fibrillation: what does it mean to be normal?. Heart Rhythm 8(4): 489-492, 2011

Inducibility of atrial fibrillation caused by acute increase of atrial pressure in rat diseased heart with chronic atrial dilation. International Heart Journal 53(4): 257-260, 2012

Repetitive electrical remodeling by paroxysms of atrial fibrillation in the goat: No cumulative effect on inducibility or stability of atrial fibrillation. Journal of Cardiovascular Electrophysiology 10(8): 1101-1108, 1999

Inducibility of atrial fibrillation depends not on inflammation but on atrial structural remodeling in rat experimental autoimmune myocarditis. Cardiovascular Pathology 19(5): E149-E157, 2011

Inducibility of atrial fibrillation with a synchronized external low energy shock post-pulmonary vein isolation predicts recurrent atrial fibrillation. Journal of Cardiovascular Electrophysiology 20(1): 29-36, 2008

Inducibility of paroxysmal atrial fibrillation by isoproterenol and its relation to the mode of onset of atrial fibrillation. Journal of Cardiovascular Electrophysiology 19(5): 466-470, 2008

Intraoperative Inducibility of Atrial Fibrillation Does Not Predict Early Postoperative Atrial Fibrillation. Journal of the American Heart Association 7(6), 2018

Intrapericardial ranolazine prolongs atrial refractory period and markedly reduces atrial fibrillation inducibility in the intact porcine heart. Journal of Cardiovascular Pharmacology 55(3): 286-291, 2010

Chronic Kidney Disease Increases Atrial Fibrillation Inducibility: Involvement of Inflammation, Atrial Fibrosis, and Connexins. Frontiers in Physiology 9: 1726-1726, 2018