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(Circulation. 2005;111:30-37.)
© 2005 American Heart Association, Inc.

Arrhythmia/Electrophysiology

Development of a Substrate of Atrial Fibrillation During Chronic Atrioventricular Block in the Goat

Hans-Ruprecht Neuberger, MD; Ulrich Schotten, MD, PhD; Sander Verheule, PhD; Sabine Eijsbouts, MD; Yuri Blaauw, MD; Arne van Hunnik, BSc; Maurits Allessie, MD, PhD

From the Department of Physiology, University of Maastricht, the Netherlands. Dr Neuberger is now at the Medizinische Klinik und Poliklinik, Innere Medizin III, Universitätskliniken des Saarlandes, Homburg, Germany.

Correspondence to Prof M.A. Allessie, Department of Physiology, Cardiovascular Research Institute Maastricht, University of Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands. E-mail m.allessie{at}fys.unimaas.nl

Received April 2, 2004; revision received July 19, 2004; accepted October 12, 2004.

Background— Atrial dilatation is an important risk factor for atrial fibrillation (AF). In the present study, we monitored the electrophysiological changes during progressive atrial dilatation in chronically instrumented goats.

Methods and Results— In 8 goats, 2 screw-in leads with piezoelectric crystals were implanted transvenously in the right atrium. After 2 weeks, atrial diameter and effective refractory period were measured. AF paroxysms were induced by burst pacing to determine the baseline AF cycle length and stability of AF. After His-bundle ablation, the above measurements were repeated once a week. After 4 weeks of complete AV block, the free wall of the right atrium was mapped and the atrium was fixed in formalin for histological analysis. After His-bundle ablation, the ventricular rate decreased from 113.8±4.8 to 44.6±2.5 bpm. Right atrial diameter increased gradually by 13.5±3.9% during 4 weeks of AV block (P<0.01). The duration of induced AF paroxysms increased from 4.6 seconds to 6.4 minutes (P<0.05). Atrial effective refractory period and AF cycle length remained constant. Spontaneous paroxysms of AF were not observed. Atrial mapping during rapid pacing revealed that slow conduction (<30 cm/s) was present in 3.7±1.0% of the mapped area (control, 0.9±0.5%, P<0.05). Histological analysis showed hypertrophy without atrial fibrosis. Connexin40 and connexin43 expression was unchanged.

Conclusions— Chronic AV block in the goat leads to progressive atrial dilatation, prolongation of induced AF paroxysms, and local conduction delays. The increase in AF stability was not a result of a shortening of atrial refractoriness or atrial fibrosis.

Key Words: electrophysiology • atrium • fibrillation • dilatation • mapping

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