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Heterogeneous Changes in Electrophysiologic Properties in the Paroxysmal and Chronically Fibrillating Human Atrium

Heterogeneous Changes in Atrial Electrophysiologic Properties. Introduction: The regional changes in atrial elettrophysiologic properties related to atrial fibrillation (AF) in patients with paroxysmal AF (PAF) and chronic AF (CAF) remain unclear. The purpose of this study was to investigate the regional changes in atrial electrophysiology in patients with AF. Methods and Results: We evaluated the atrial electrophysiology at different sites (high right atrium, low right atrium [LRAJ, and distal coronary sinus [DCS]) in 11 patients with CAF, 8 patients with PAF, and 10 controls. Patients with CAF had significantly prolonged interatrial conduction and corrected sinus node recovery time, and shortened atrial effective refractory period (ERP) with loss of rate‐related adaptation in the DCS, hut had paradoxic prolongation of atrial ERP in the LRA, as compared with patients with PAF and the controls. As a result, the spatial distribution of atrial ERP that was observed in the controls and in patients with PAF was reversed in patients with CAF, without an increase in the dispersion of atrial refractoriness. Patients with PAF showed intermediate changes in atrial conduction times and atrial refractoriness as compared with patients with CAF and controls.