Response by Álvarez-García et al to Letters Regarding Article, “Electrophysiological Effects of Selective Atrial Coronary Artery Occlusion in Humans”
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We thank Drs Ng and Efimov and Dr Baranchuk for their interest in our article1 and for addressing the mechanistic aspects of human atrial pathophysiology.
On the basis of their own studies in human left ventricular wedge preparations,2,3 in their letter, Ng and Efimov raise a clinically relevant and plausible hypothesis that atrial ischemia might be more arrhythmogenic in the presence of heart failure. Unfortunately, our study cannot elucidate this assumption because, among our 17 patients with atrial coronary occlusion, only 2 presented with depressed (<45%) left ventricular ejection fraction and only 1 patient with overt heart failure. Therefore, in these circumstances, we could not appreciate an association between the …