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¿Son reversibles los cambios electrofisiológicos inducidos por una fibrilación auricular de mayor duración?
L M Rodriguez1, C Timmermans, H J Wellens
1Department of Cardiology, Academic Hospital, Maastricht, The Netherlands. L.M.Rodriguez@cardio.azm.nl
Circulation
|July 14, 1999
Resumen
La fibrilación auricular (FA) se mantuvo inducible después de un ritmo sinusal prolongado en la mayoría de los pacientes con antecedentes de FA de larga duración. La electrofisiología auricular no se normalizó, lo que indica cambios persistentes incluso después de un tratamiento exitoso.
Área de la Ciencia:
- Cardiología Cardiología.
- Electrofisiología y electrofisiología.
- Las arritmias cardíacas son arritmias cardíacas.
Sus antecedentes:
- Los estudios en animales sugieren que la fibrilación auricular prolongada (FA) altera el período refractario efectivo auricular (AERP).
- El impacto de la FA a largo plazo en la electrofisiología auricular en humanos requiere más investigación.
Objetivo del estudio:
- Para evaluar la electrofisiología auricular después de un ritmo sinusal prolongado en pacientes con FA recurrente y de larga duración tratados con el Metrix Atrioverter.
- Para analizar los efectos de la cardioversión rápida en la recurrencia de la FA y la duración del ritmo sinusal.
Principales métodos:
- Se realizaron estudios electrofisiológicos en cuatro pacientes con FA recurrente (duración 3-21 años) después de la implantación de Atrioverter.
- El período refractario atrial efectivo (AERP) se midió antes de la implantación y después de >1000 horas de ritmo sinusal.
- La inducibilidad de la fibrilación auricular (FA) se evaluó utilizando un solo latido auricular prematuro.
Principales resultados:
- La FA se mantuvo inducible por un solo latido atrial prematuro en 3 de 4 pacientes después de un ritmo sinusal prolongado (>1000 horas).
- En un paciente, la FA no fue inducible, y las mediciones de AERP fueron similares a los valores previos a la implantación.
- No se observó normalización de la electrofisiología auricular en pacientes con antecedentes de FA recurrente de mayor duración.
Conclusiones:
- La FA recurrente de larga duración conduce a cambios electrofisiológicos persistentes en las aurículas.
- La electrofisiología auricular no se recupera completamente a patrones normales incluso después de períodos prolongados de ritmo sinusal y tratamiento exitoso de AF.
- La inducibilidad de la FA por un solo latido prematuro persiste en la mayoría de los pacientes con antecedentes de FA de larga data.
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