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Paroxysmal atrial fibrillation initiated by rapid atrial tachycardia I. Rapid atrial tachycardia AT initiated atrial fibrillation AFThe coupling interval of the first beat of AT is 460 msec. It showed warm-up phenomenon over 34 beats and then rapidly accelerated to 300 bpm CL, 200 msec.
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Paroxysmal atrial fibrillation (PAF) causes not only severe symptoms and hemodynamic changes, but may progress to chronic atrial fibrillation. Autonomic nervous system or atrial premature beat (APB) has been suggested to contribute to the spontaneous initiation of PAF, but the exact mechanism has been largely unknown.
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Citations
... Our experimental conditions paralleled the clinical situations of the burst PV firing 17) in acute tachycardiainduced atrial remodeling. In the acute stage of atrial fibrillation or tachycardia, cellular Ca ++ -overload develops. ...
Background and Objectives：The mechanism responsible for the generation of ectopic beats in pulmonary veins (PVs) remains to be well defined. The present study examines the electrophysiological characteristics of the PVs and other regions of the canine left atrium (LA) under low dose (300 μM) caffeine condition. Materials and Methods：Transmembrane action potentials were recorded from the left superior PVs, PV-LA junctions (PLJ, atrium <5 mm from the PV ostium), LA appendage (LAA) or Bachmann's bundle (BB) in arterially perfused canine LA-PV preparations, using floating glass microelectrodes. Rapid atrial pacing (cycle lengths 140-300 ms, 10 sec) was used to induce delayed afterdepolarizations (DAD) at the baseline and under low dose (300 μM) caf-feine conditions. Results：Spontaneous diastolic depolarization or triggered activity (TA) was not observed in any of the recording area under the baseline condition. DAD and TA were induced by caffeine in 4/8 PVs and in 3/8 PLJs, but in no LAA (0/6) or BB (0/5). These TA and DAD were also observed after termination of pacing-in-duced atrial tachyarrhythmia. DAD was abolished by pretreatment of the atria with verapamil or propranolol (1.0 μM). Conclusion：Spontaneous diastolic depolarization was not present in perfused canine left atria or proxi-mal PV. Pulmonary veins and adjacent areas displayed an increased susceptibility to develop DAD-induced TA under low dose caffeine condition. This distinctive electrophysiological property of the PV and PLJ area may con-tribute to the arrhythmogenic substrate responsible for the ectopic activity that initiates atrial fibrillation. (Korean Circulation J 2005;35:643-648) KEY WORDS：Pulmonary veins；Calcium；Atrial fibrillation.
