Relation between cycle length, volume, and pressure in type I atrial flutter

Détails

ID Serval
serval:BIB_49C4C832E80A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Relation between cycle length, volume, and pressure in type I atrial flutter
Périodique
Pacing and Clinical Electrophysiology
Auteur(s)
Vulliemin  P., Del Bufalo  A., Schlaepfer  J., Fromer  M., Kappenberger  L.
ISSN
0147-8389 (Print)
Statut éditorial
Publié
Date de publication
08/1994
Volume
17
Numéro
8
Pages
1391-8
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Aug
Résumé
Assuming that type I atrial flutter is a macroreentrant circuit, its cycle length should vary with the atrial dimensions. In order to test this hypothesis, flutter cycle length was measured while inducing atrial volume and pressure changes by postural and pharmacological means in seven patients undergoing a therapeutic programmed stimulation for type I atrial flutter conversion. Right atrial volume was estimated from B-mode echocardiography data. Basal values were compared with those obtained during inspiration, expiration, Valsalva maneuver, negative tilt (head down), and positive tilt (head up) with 0.8-1.6 mg p.o. nitroglycerin. The right atrial size increased slightly from 17.8 to 18.3 cm2 (P = 0.04) during the pressure load induced by negative tilt (+3 mmHg), with a corresponding lengthening of the flutter cycle length from 228 to 233 msec (P = 0.02). Similarly, pressure unloading of -2 mmHg by positive tilting and nitrates was accompanied by a decrease in right atrial size to 16.6 cm2 (P = 0.04), with a corresponding decrease in cycle length from 228 to 219 msec (P = 0.03). Respiratory maneuver yielded similar results with an inspiratory cycle lengthening, expiratory shortening, and further shortening during Valsalva maneuver. These experiments demonstrate a direct relation between cycle length and atrial volume in human type I atrial flutter. They underline the importance of the right heart preload and atrial size for the electrophysiological characteristics of type I atrial flutter. Beside its fundamental interest, this finding is important for the understanding of the mechanism of maintenance and therapeutic responses of this common arrhythmia.
Mots-clé
Atrial Flutter/*physiopathology Atrial Function, Right/drug effects/physiology Blood Pressure/drug effects/*physiology Cardiac Output/physiology Cardiac Volume/drug effects/*physiology Central Venous Pressure/physiology Echocardiography Electrocardiography Female Heart Atria/physiopathology/ultrasonography Heart Rate/drug effects/*physiology Humans Male Middle Aged Nitroglycerin/pharmacology Posture/physiology
Pubmed
Web of science
Création de la notice
28/01/2008 11:09
Dernière modification de la notice
20/08/2019 14:57
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