Arterial hypertension drives arrhythmia progression via specific structural remodeling in a porcine model of atrial fibrillation
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Arterial hypertension drives arrhythmia progression via specific structural remodeling in a porcine model of atrial fibrillation. / Manninger, Martin; Zweiker, David; van Hunnik, Arne; Alogna, Alessio; Prassl, Anton J; Schipke, Julia; Zeemering, Stef; Zirngast, Birgit; Schönleitner, Patrick; Schwarzl, Michael; Herbst, Viktoria; Thon-Gutschi, Eva; Huber, Stefan; Rohrer, Ursula; Ebner, Jakob; Brussee, Helmut; Pieske, Burkert M; Heinzel, Frank R; Verheule, Sander; Antoons, Gudrun; Lueger, Andreas; Mühlfeld, Christian; Plank, Gernot; Schotten, Ulrich; Post, Heiner; Scherr, Daniel.
In: HEART RHYTHM, Vol. 15, No. 9, 09.2018, p. 1328-1336.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Arterial hypertension drives arrhythmia progression via specific structural remodeling in a porcine model of atrial fibrillation
AU - Manninger, Martin
AU - Zweiker, David
AU - van Hunnik, Arne
AU - Alogna, Alessio
AU - Prassl, Anton J
AU - Schipke, Julia
AU - Zeemering, Stef
AU - Zirngast, Birgit
AU - Schönleitner, Patrick
AU - Schwarzl, Michael
AU - Herbst, Viktoria
AU - Thon-Gutschi, Eva
AU - Huber, Stefan
AU - Rohrer, Ursula
AU - Ebner, Jakob
AU - Brussee, Helmut
AU - Pieske, Burkert M
AU - Heinzel, Frank R
AU - Verheule, Sander
AU - Antoons, Gudrun
AU - Lueger, Andreas
AU - Mühlfeld, Christian
AU - Plank, Gernot
AU - Schotten, Ulrich
AU - Post, Heiner
AU - Scherr, Daniel
N1 - Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
PY - 2018/9
Y1 - 2018/9
N2 - BACKGROUND: Arterial hypertension (HT) contributes to progression of atrial fibrillation (AF) via unknown mechanisms.OBJECTIVE: We aimed to characterize electrical and structural changes accounting for increased AF stability in a large animal model of rapid atrial pacing (RAP)-induced AF combined with desoxycorticosterone acetate (DOCA)-induced HT.METHODS: Eighteen pigs were instrumented with right atrial endocardial pacemaker leads and custom-made pacemakers to induce AF by continuous RAP (600 beats/min). DOCA pellets were subcutaneously implanted in a subgroup of 9 animals (AF+HT group); the other 9 animals served as controls (AF group). Final experiments included electrophysiology studies, endocardial electroanatomic mapping, and high-density mapping with epicardial multielectrode arrays. In addition, 3-dimensional computational modeling was performed.RESULTS: DOCA implantation led to secondary HT (median [interquartile range] aortic pressure 109.9 [100-137] mm Hg in AF+HT vs 82.2 [79-96] mm Hg in AF; P < .05), increased AF stability (55.6% vs 12.5% of animals with AF episodes lasting >1 hour; P < .05), concentric left ventricular hypertrophy, atrial dilatation (119 ± 31 cm2 in AF+HT vs 78 ± 23 cm2 in AF; P < .05), and fibrosis. Collagen accumulation in the AF+HT group was mainly found in non-intermyocyte areas (1.62 ± 0.38 cm3 in AF+HT vs 0.96 ± 0.3 cm3 in AF; P < .05). Left and right atrial effective refractory periods, action potential durations, endo- and epicardial conduction velocities, and measures of AF complexity were comparable between the 2 groups. A 3-dimensional computational model confirmed an increase in AF stability observed in the in vivo experiments associated with increased atrial size.CONCLUSION: In this model of secondary HT, higher AF stability after 2 weeks of RAP is mainly driven by atrial dilatation.
AB - BACKGROUND: Arterial hypertension (HT) contributes to progression of atrial fibrillation (AF) via unknown mechanisms.OBJECTIVE: We aimed to characterize electrical and structural changes accounting for increased AF stability in a large animal model of rapid atrial pacing (RAP)-induced AF combined with desoxycorticosterone acetate (DOCA)-induced HT.METHODS: Eighteen pigs were instrumented with right atrial endocardial pacemaker leads and custom-made pacemakers to induce AF by continuous RAP (600 beats/min). DOCA pellets were subcutaneously implanted in a subgroup of 9 animals (AF+HT group); the other 9 animals served as controls (AF group). Final experiments included electrophysiology studies, endocardial electroanatomic mapping, and high-density mapping with epicardial multielectrode arrays. In addition, 3-dimensional computational modeling was performed.RESULTS: DOCA implantation led to secondary HT (median [interquartile range] aortic pressure 109.9 [100-137] mm Hg in AF+HT vs 82.2 [79-96] mm Hg in AF; P < .05), increased AF stability (55.6% vs 12.5% of animals with AF episodes lasting >1 hour; P < .05), concentric left ventricular hypertrophy, atrial dilatation (119 ± 31 cm2 in AF+HT vs 78 ± 23 cm2 in AF; P < .05), and fibrosis. Collagen accumulation in the AF+HT group was mainly found in non-intermyocyte areas (1.62 ± 0.38 cm3 in AF+HT vs 0.96 ± 0.3 cm3 in AF; P < .05). Left and right atrial effective refractory periods, action potential durations, endo- and epicardial conduction velocities, and measures of AF complexity were comparable between the 2 groups. A 3-dimensional computational model confirmed an increase in AF stability observed in the in vivo experiments associated with increased atrial size.CONCLUSION: In this model of secondary HT, higher AF stability after 2 weeks of RAP is mainly driven by atrial dilatation.
KW - Animals
KW - Atrial Fibrillation/etiology
KW - Atrial Remodeling
KW - Blood Pressure/physiology
KW - Computer Simulation
KW - Disease Models, Animal
KW - Electrocardiography
KW - Heart Atria/diagnostic imaging
KW - Heart Rate/physiology
KW - Hypertension/complications
KW - Pacemaker, Artificial
KW - Swine
U2 - 10.1016/j.hrthm.2018.05.016
DO - 10.1016/j.hrthm.2018.05.016
M3 - SCORING: Journal article
C2 - 29803020
VL - 15
SP - 1328
EP - 1336
JO - HEART RHYTHM
JF - HEART RHYTHM
SN - 1547-5271
IS - 9
ER -
