Age-Related Changes in the Electrophysiologic Properties of the Atrium in Patients with no History of Atrial Fibrillation
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概要
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Although atrial fibrillation is a common arrhythmia, especially in the elderly, little is known about age-related changes in the electrophysiologic properties of the atrium. The aim of this study was to analyze the effect of aging on atrial vulnerability to atrial fibrillation. An electrophysiologic study was performed in 45 patients with no history of atrial fibrillation, Wolff-Parkinson-White syndrome, structural heart disease, or conditions with potential effects on cardiac hemodynamic or electrophysiologic function (15 females; mean age, 52 ± 18 years; range, 14 to 84 years). The following atrial excitability parameters were assessed: spontaneous or paced (A1) and extrastimulated (A2) atrial electrogram widths, percent maximum atrial fragmentation (A2/A1 × 100), effective refractory period, wavelength index (ERP/A2), and inducibility of atrial fibrillation. Atrial fibrillation was induced in 9 patients. Percent maximum atrial fragmentation was greater (176 ± 36 vs 137 ± 26%, P < 0.001) and wavelength index was shorter (2.4 ± 0.4 vs 3.2 ± 0.9, P < 0.01) in the patients with than without inducible atrial fibrillation. However, age was similar in patients with and without inducible atrial fibrillation (47 ± 11 vs 53 ± 19 years, P = 0.36). Percent maximum atrial fragmentation and effective refractory period directly correlated with age (r = 0.32, P < 0.05 and r = 0.45, P < 0.001, respectively). On the other hand, wavelength index (3.1 ± 0.9) did not correlate with age (r = -0.05, P = 0.77). This study suggests that the mechanism triggering atrial fibrillation may be very well different between older and younger patients with atrial fibrillation, because younger patients have no marked substrate for atrial fibrillation.
著者
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NADA Teru
Department of Cardiology and Clinical Research, National Zentsuji Hospital
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Tamura Y
Department Of Anatomy And Cell Science Kansai Medical University
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Oki T
Second Department Of Internal Medicine Tokushima University School Of Medicine
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Sakabe K
Department Of Human Structure And Function Tokai University School Of Medicine
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Fukuda N
Department Of Biochemistry And Applied Biosciences Faculty Of Agriculture University Of Miyazaki
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Nishikado A
Second Department Of Internal Medicine School Of Medicine The University Of Tokushima
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Shinohara H
Department Of Anatomy Kanazawa Medical University
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OKI Takashi
Second Department of Internal Medicine, School of Medicine, University of Tokushima
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Sakabe Koichi
Department of Cardiology and Clinical Research, National Zentsuji Hospital
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Nishikado Akiyoshi
Second Department of Internal Medicine, School of Medicine, University of Tokushima
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Nada T
Department of Cardiology and Clinical Research, National Zentsuji Hospital
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Wakatsuki T
Second Department of Internal Medicine, School of Medicine, University of Tokushima
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Shinohara Hisanori
Department of Cardiology and Clinical Research, National Zentsuji Hospital
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Tamura Yoshiyuki
Department of Cardiology and Clinical Research, National Zentsuji Hospital
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