Conduction Heterogeneity

• Published in: JACC. Clinical electrophysiology 2020-12, Vol.6 (14), p.1844-1854
• Main Authors: Heida, Annejet, van der Does, Willemijn F.B., van Staveren, Lianne N., Taverne, Yannick J.H.J., Roos-Serote, Maarten C., Bogers, Ad J.J.C., de Groot, Natasja M.S.
• Format: Article
• Language: English
• Subjects: atrial fibrillation; cardiac surgery; conduction disorders; heart disease; sinus rhythm
• ISSN: 2405-500X; 2405-5018
• DOI: 10.1016/j.jacep.2020.09.030

The goal of this study is to investigate the impact of various underlying heart diseases (UHDs) and prior atrial fibrillation (AF) episodes on conduction heterogeneity. It is unknown whether intra-atrial conduction during sinus rhythm differs between various UHD or is influenced by AF episodes. Epicardial sinus rhythm mapping of the right atrium, Bachmann’s bundle (BB), left atrium and pulmonary vein area was performed in 447 participants (median age: 67 [interquartile range (IQR): 59 to 73] years) with or without AF undergoing cardiac surgery for ischemic heart disease, (ischemic and) valvular heart disease, or congenital heart disease. Conduction times (CTs) were defined as Δ local activation time between 2 adjacent electrodes and used to assess frequency (CTs ≥ 4 ms) and magnitude of conduction disorders (in increments of 10 ms). When comparing the 3 types of UHD, there were no differences in frequencies and magnitude of CTs at all locations (p ≥ 0.017 and p ≥ 0.005, respectively). Prior AF episodes were associated with conduction slowing throughout both atria (14.9% [IQR: 11.8 to 17.0] vs. 12.8% [IQR: 10.9 to 14.6]; p