Relevance of Conduction Disorders in Bachmann's Bundle During Sinus Rhythm in Humans.
Circ Arrhythm Electrophysiol
; 9(5): e003972, 2016 May.
Article
em En
| MEDLINE
| ID: mdl-27153879
ABSTRACT
BACKGROUND:
Bachmann's bundle (BB) is considered to be the main route of interatrial conduction and to play a role in development of atrial fibrillation (AF). The goals of this study are to characterize the presence of conduction disorders in BB during sinus rhythm and to study their relation with AF. METHODS ANDRESULTS:
High-resolution epicardial mapping (192 unipolar electrodes, interelectrode distance 2 mm) of sinus rhythm was performed in 185 patients during coronary artery bypass surgery of whom 13 had a history of paroxysmal AF. Continuous rhythm monitoring was used to detect postoperative AF during the first 5 postoperative days. In 67% of the patients, BB was activated from right to left; in the remaining patients from right and middle (21%), right, central, and left (8%), or central (4%) site. Mean effective conduction velocity was 89 cm/s. Conduction block was present in most patients (75%; median 1.1%, range 0-12.8) and was higher in patients with paroxysmal AF compared with patients without a history of AF (3.2% versus 0.9%; P=0.03). A high amount of conduction block (>4%) was associated with de novo postoperative AF (P=0.02). Longitudinal lines of conduction block >10 mm were also associated with postoperative AF (P=0.04).CONCLUSIONS:
BB may be activated through multiple directions, but the predominant route of conduction is from right to left. Conduction velocity across BB is around 90 cm/s. Conduction is blocked in both longitudinal and transverse direction in the majority of patients. Conduction disorders, particularly long lines of longitudinal conduction block, are more pronounced in patients with AF episodes.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Taquicardia Paroxística
/
Processamento de Sinais Assistido por Computador
/
Fascículo Atrioventricular
/
Eletrodos Implantados
/
Mapeamento Epicárdico
/
Frequência Cardíaca
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article