Circulation, Vol 84, 1689-1697, Copyright © 1991 by American Heart Association
M Allessie, C Kirchhof, GJ Scheffer, F Chorro and J Brugada
BACKGROUND. In five chronically instrumented conscious dogs, we studied the
effects of rapid pacing on sustained electrically induced atrial
fibrillation. METHODS AND RESULTS. Twenty-three unipolar atrial
electrograms were recorded simultaneously from the bundle of Bachmann and
the lateral wall of the right and left atria. During sustained atrial
fibrillation, the surface electrocardiogram showed continuous
irregularities of the baseline without P or F waves as well as an irregular
ventricular rhythm with narrow QRS complexes. The atrial electrograms
showed rapid irregular activity with a median cycle length of 85 +/- 8 msec
and a range (P5-95) of 33 +/- 18 msec. Overdrive pacing of atrial
fibrillation was performed using symmetric biphasic rectangular stimuli
(2-msec duration, sixfold that of threshold) applied to a pair of
stimulating electrodes at the left atrial appendage. Stimulation was
started at pacing intervals of about 10 msec longer than the local median
fibrillation interval and subsequently shortened in steps of 1 msec. At a
critical pacing interval slightly shorter than the median fibrillation
interval, the atrium around the pacing site was suddenly captured by the
electrical stimuli. The area of local capture had a diameter of 6.1 +/- 1.6
cm. The time window of capture was 12 +/- 4 msec. CONCLUSIONS. These
observations show that during electrically induced atrial fibrillation in
chronically instrumented conscious dogs, a short excitable gap is present,
permitting regional control of the fibrillatory process by rapid pacing.
ARTICLES
Regional control of atrial fibrillation by rapid pacing in conscious dogs
Department of Physiology, University of Limburg, Maastricht, The Netherlands.
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