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Electrophysiologic and electroanatomic changes in the human atrium associated with age
Peter M Kistler1, Prashanthan Sanders, Simon P Fynn
1Department of Cardiology, Royal Melbourne Hospital, Australia.
Journal of the American College of Cardiology
|July 6, 2004
Summary
Human aging causes electrical and structural changes in the atria, increasing the risk of atrial fibrillation (AF). These changes include slower conduction and altered electrical properties, potentially explaining AF prevalence in older adults.
Area of Science:
- Cardiology
- Electrophysiology
- Gerontology
Background:
- Atrial fibrillation (AF) affects 3-4% of individuals over 65.
- AF is linked to serious complications like thromboembolism and heart failure.
- The specific electrical and structural remodeling of the atria with human aging is not well understood.
Purpose of the Study:
- To characterize the atrial remodeling patterns associated with human aging.
- To investigate age-related changes in atrial electrical properties and structure.
Main Methods:
- Conventional electrophysiologic studies and electroanatomic mapping were performed on three patient groups: <30 years, 31-59 years, and >60 years.
- Key parameters measured included atrial refractoriness (ERP), sinus node recovery time (CSNRT), P-wave duration (PWD), conduction time (CT), and discrete double potentials (DPs).
- Specific measurements were taken at the coronary sinus (CS), right atrium (RA), and crista terminalis.
Main Results:
- Aging correlated with increased atrial ERP, prolonged CT in the CS, and longer PWD and CSNRT.
- Electroanatomic mapping revealed diffuse low-voltage areas and regional conduction slowing.
- An increased incidence of DPs and fractionated signals along the crista terminalis was observed with aging.
Conclusions:
- Human aging is associated with regional conduction slowing and structural atrial changes, including low-voltage areas.
- Age-related remodeling involves impaired sinus node function and increased atrial ERP.
- These electrical and structural modifications may underlie the heightened susceptibility to atrial fibrillation in older individuals.