Published Online
on March 3, 2003

A more recent version of this article appeared on March 18, 2003

This Article Full Text (PDF) All Versions of this Article: 107/10/1433    most recent 01.CIR.0000055314.10801.4Fv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schotten, U. Articles by Allessie, M. Search for Related Content PubMed PubMed Citation Articles by Schotten, U. Articles by Allessie, M. Pubmed/NCBI databases Medline Plus Health Information Atrial Fibrillation Related Collections Calcium cycling/excitation-contraction coupling Arrhythmias, clinical electrophysiology, drugs Risk Factors for Stroke

Submitted on October 25, 2002
Revised on December 5, 2002
Accepted on December 5, 2002

Electrical and Contractile Remodeling During the First Days of Atrial Fibrillation Go Hand in Hand

Ulrich Schotten MD^*, Mattias Duytschaever MD, Jannie Ausma PhD, Sabine Eijsbouts MD, Hans-Ruprecht Neuberger MD, and Maurits Allessie MD, PhD

From the Department of Physiology, University of Maastricht, the Netherlands.

^* To whom correspondence should be addressed. E-mail: Schotten{at}fys.unimaas.nl.

Background--The mechanisms of the atrial contractile dysfunction induced by atrial fibrillation (AF) are not completely understood. In particular, the relation between the atrial dysfunction and electrical remodeling has not yet been studied.

Methods and Results--Seven goats were chronically instrumented with electrodes sutured to the atria and with ultrasonic piezoelectric crystals to record the atrial diameters. A pressure transducer was implanted in the right atrium. After 5 minutes, 3 hours, and throughout the first 5 days of artificially maintained AF, atrial contractile function was measured and the atrial effective refractory period (AERP) was monitored for comparison. Also, the positive inotropic effects of the L-type Ca²⁺-channel agonist BayY5959 and short trains of rapid atrial pacing were studied. After resumption of sinus rhythm, the recovery of atrial contractile function was followed. After 5 minutes of AF, atrial contractility was decreased by 55% but recovered completely within 10 minutes. Five days of AF nearly completely abolished the atrial contractile function, and recovery took 2 days. During the first days of AF, the development of the contractile dysfunction followed the same time course as the shortening of AERP (electrical remodeling). In remodeled atria, BayY5959 increased atrial contractility to the same extent as it prolonged AERP. The inotropic effect of short trains of rapid atrial pacing was similar in normal and remodeled atria.

Conclusions--Depending on the duration of AF, different mechanisms contribute to the AF-induced atrial hypocontractility. Atrial contractile remodeling during several days of AF goes hand in hand with electrical remodeling and might be caused by a reduction of the L-type Ca²⁺-current.

Key words: arrhythmia • atrium • contractility • remodeling

This article has been cited by other articles:

				K. Nishida, G. Michael, D. Dobrev, and S. Nattel Animal models for atrial fibrillation: clinical insights and scientific opportunities Europace, October 29, 2009; (2009) eup328v1. [Abstract] [Full Text] [PDF]

				A. J. Camm, P. Kirchhof, G. Y.H. Lip, I. Savelieva, and S. Ernst CHAPTER 29 Atrial Fibrillation ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]

				B. S. Stambler and K. R. Laurita Atrial Fibrillation in Heart Failure: Steady Progress but Still a Long Way to Go Circ Arrhythm Electrophysiol, June 1, 2008; 1(2): 77 - 79. [Full Text] [PDF]

				C. Schneider, R. Malisius, K. Krause, F. Lampe, E. Bahlmann, S. Boczor, M. Antz, S. Ernst, and K.-H. Kuck Strain rate imaging for functional quantification of the left atrium: atrial deformation predicts the maintenance of sinus rhythm after catheter ablation of atrial fibrillation Eur. Heart J., June 1, 2008; 29(11): 1397 - 1409. [Abstract] [Full Text] [PDF]

				C. A. Carnes, P. M. L. Janssen, M. L. Ruehr, H. Nakayama, T. Nakayama, H. Haase, J. A. Bauer, M. K. Chung, I. M. Fearon, A. M. Gillinov, et al. Atrial Glutathione Content, Calcium Current, and Contractility J. Biol. Chem., September 21, 2007; 282(38): 28063 - 28073. [Abstract] [Full Text] [PDF]

				A. K Nergardh, M. Rosenqvist, R. Nordlander, and M. Frick Maintenance of sinus rhythm with metoprolol CR initiated before cardioversion and repeated cardioversion of atrial fibrillation: a randomized double-blind placebo-controlled study Eur. Heart J., June 1, 2007; 28(11): 1351 - 1357. [Abstract] [Full Text] [PDF]

				U. Schotten, S. de Haan, S. Verheule, E. G.A. Harks, D. Frechen, E. Bodewig, M. Greiser, R. Ram, J. Maessen, M. Kelm, et al. Blockade of atrial-specific K+-currents increases atrial but not ventricular contractility by enhancing reverse mode Na+/Ca2+-exchange Cardiovasc Res, January 1, 2007; 73(1): 37 - 47. [Abstract] [Full Text] [PDF]

				S. de Haan, M. Greiser, E. Harks, Y. Blaauw, A. van Hunnik, S. Verheule, M. Allessie, and U. Schotten AVE0118, Blocker of the Transient Outward Current (Ito) and Ultrarapid Delayed Rectifier Current (IKur), Fully Restores Atrial Contractility After Cardioversion of Atrial Fibrillation in the Goat Circulation, September 19, 2006; 114(12): 1234 - 1242. [Abstract] [Full Text] [PDF]

				M. E.W. Hemels, T. Van Noord, H. J.G.M. Crijns, D. J. Van Veldhuisen, N. J.G.M. Veeger, H. A. Bosker, A. C.P. Wiesfeld, M. P. Van den Berg, A. V. Ranchor, and I. C. Van Gelder Verapamil Versus Digoxin and Acute Versus Routine Serial Cardioversion for the Improvement of Rhythm Control for Persistent Atrial Fibrillation J. Am. Coll. Cardiol., September 5, 2006; 48(5): 1001 - 1009. [Abstract] [Full Text] [PDF]

				F. Holmqvist, M. Stridh, J. E.P. Waktare, L. Sornmo, S. B. Olsson, and C. J. Meurling Atrial fibrillatory rate and sinus rhythm maintenance in patients undergoing cardioversion of persistent atrial fibrillation Eur. Heart J., September 2, 2006; 27(18): 2201 - 2207. [Abstract] [Full Text] [PDF]

				A. Goette and U. Schotten Inhibition of angiotensin II type 1 receptors reduces atrial stunning and spontaneous echo contrast after electrical cardioversion of atrial fibrillation Eur. Heart J., September 1, 2006; 27(17): 2034 - 2035. [Full Text] [PDF]

				R. H. Falk Rate Control Is Preferable to Rhythm Control in the Majority of Patients With Atrial Fibrillation Circulation, June 14, 2005; 111(23): 3141 - 3150. [Full Text] [PDF]

				T. Arts, T. Delhaas, P. Bovendeerd, X. Verbeek, and F. W. Prinzen Adaptation to mechanical load determines shape and properties of heart and circulation: the CircAdapt model Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1943 - H1954. [Abstract] [Full Text] [PDF]

				U. Schotten, S. de Haan, H.-R. Neuberger, S. Eijsbouts, Y. Blaauw, R. Tieleman, and M. Allessie Loss of atrial contractility is primary cause of atrial dilatation during first days of atrial fibrillation Am J Physiol Heart Circ Physiol, November 1, 2004; 287(5): H2324 - H2331. [Abstract] [Full Text] [PDF]

				L. Hove-Madsen, A. Llach, A. Bayes-Genis, S. Roura, E. R. Font, A. Aris, and J. Cinca Atrial Fibrillation Is Associated With Increased Spontaneous Calcium Release From the Sarcoplasmic Reticulum in Human Atrial Myocytes Circulation, September 14, 2004; 110(11): 1358 - 1363. [Abstract] [Full Text] [PDF]

				C. A. Palin, R. Kailasam, and C. W. Hogue Jr Atrial Fibrillation After Cardiac Surgery: Pathophysiology and Treatment Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2004; 8(3): 175 - 183. [Abstract] [PDF]