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Mechanisms Underlying the Development of Atrial Arrhythmias in Heart Failure

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Abstract

There is an important association between heart failure and the development of atrial arrhythmias. Although most often associated with atrial fibrillation, there is some evidence to suggest an association between heart failure and other atrial arrhythmias and, in particular, atrial flutter and atrial tachycardia. The mechanisms by which these common atrial arrhythmias may arise in patients with heart failure are discussed.

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References

  1. Doshi RN, Wu TJ, Yashima M, et al. Relation between ligament of Marshall and adrenergic atrial tachyarrhythmia. Circulation1999;100:87–883.

    Google Scholar 

  2. Hwang C, Karagueuzian HS, Chen PS. Idiopathic paroxysmal atrial fibrillation induced by a focal discharge mechanism in the left superior pulmonary vein: Possible roles of the ligament of Marshall. J Cardiovasc Electrophysiol 1999;10:63–648.

    Google Scholar 

  3. Nakashima H, Kumagai K, Urata H, Gondo N, Ideishi M, Arakawa K. Angiotensin II antagonist prevents electrical remodeling in atrial fibrillation. Circulation 2000;101:261–2617.

    Google Scholar 

  4. Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and Implications. Arch.Intern.Med.1995;155:46–473.

    Google Scholar 

  5. Ryder KM, Benjamin EJ. Epidemiology and significance of atrial fibrillation. Am J Cardiol1999;84:131R-138R.

    Google Scholar 

  6. Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol1994;74:23–241.

    Google Scholar 

  7. Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: The Framingham Study. N Engl J Med1982;306:101–1022.

    Google Scholar 

  8. Psaty BM, Manolio TA, Kuller LH, et al. Incidence of and risk factors for atrial fibrillation in older adults. Circulation 1997;96:245–2461.

    Google Scholar 

  9. Jais P, Peng JT, Shah DC, et al. Left ventricular diastolic dysfunction in patients with so-called lone atrial fibrillation [in process citation]. J Cardiovasc Electrophysiol 2000;11:62–625.

    Google Scholar 

  10. Linderer T, Chatterjee K, Parmley WW, Sievers RE, Glantz SA, Tyberg JV. Influence of atrial systole on the Frank-Starling relation and the end-diastolic pressure-diameter relation of the left ventricle. Circulation 1983;67:104–1053.

    Google Scholar 

  11. Naito M, David D, Michelson EL, Schaffenburg M, Dreifus LS. The hemodynamic consequences of cardiac arrhythmias: Evaluation of the relative roles of abnormal atrioventricular sequencing, irregularity of ventricular rhythm and atrial fibrillation in a canine model.AmHeart J1983;106:28–291.

    Google Scholar 

  12. Daoud EG, Weiss R, Bahu M, et al. Effect of an irregular ventricular rhythm on cardiac output. Am J Cardiol1996;78:143–1436.

    Google Scholar 

  13. Gosselink AT, Blanksma PK, Crijns HJ, et al. Left ventricular beat-to-beat performance in atrial fibrillation: Contribution of Frank-Starling mechanism after short rather than long RR intervals. J Am Coll Cardiol1995;26:151–1521.

    Google Scholar 

  14. Chiladakis JA, Vassilikos VP, Maounis TN, Cokkinos DV, Manolis AS. Successful radiofrequency catheter ablation of automatic atrial tachycardia with regression of the cardiomyopathy picture. Pacing Clin Electrophysiol 1997;20:95–959.

    Google Scholar 

  15. Cruz FE, Cheriex EC, Smeets JL, et al. Reversibility of tachycardia-induced cardiomyopathy after cure of incessant supraventricular tachycardia. J Am Coll Cardiol1990;16:73–744.

    Google Scholar 

  16. Fishberger SB, Colan SD, Saul JP, Mayer JEJ, Walsh EP. Myocardial mechanics before and after ablation of chronic tachycardia. Pacing Clin Electrophysiol1996;19:4–49.

    Google Scholar 

  17. Rinaldi CA, Thompson DS. Tachycardia-induced cardiomyopathy caused by atrial flutter responding to DC cardioversion. Hosp Med1999;60:30–306.

    Google Scholar 

  18. Burchell SA, Spinale FG, Crawford FA, Tanaka R, Zile MR. Effects of chronic tachycardia-induced cardiomyopathy on the beta-adrenergic receptor system. J Thorac Cardiovasc Surg1992;104:100–1012.

    Google Scholar 

  19. Spinale FG, Tempel GE, Mukherjee R, et al. Cellular and molecular alterations in the beta adrenergic system with cardiomyopathy induced by tachycardia. Cardiovasc Res1994;28:124–1250.

    Google Scholar 

  20. Spinale FG, Tanaka R, Crawford FA, Zile MR. Changes in myocardial blood flow during development of and recovery from tachycardia-induced cardiomyopathy. Circulation 1992;85:71–729.

    Google Scholar 

  21. Spinale FG, Clayton C, Tanaka R, et al. Myocardial Na+,K+-ATPase in tachycardia induced cardiomyopathy. J Mol Cell Cardiol1992;24:27–294.

    Google Scholar 

  22. Eble DM, Spinale FG. Contractile and cytoskeletal content, structure, and mRNA levels with tachycardiainduced cardiomyopathy. Am J Physiol1995;268:H242– H2439.

    Google Scholar 

  23. Mukherjee R, Hewett KW, Spinale FG. Myocyte electrophysiological properties following the development of supraventricular tachycardia-induced cardiomyopathy. J Mol Cell Cardiol1995;27:133–1348.

    Google Scholar 

  24. Grogan M, Smith HC, Gersh BJ, Wood DL. Left ventricular dysfunction due to atrial fibrillation in patients initially believed to have idiopathic dilated cardiomyopathy. Am J Cardiol1992;69:157–1573.

    Google Scholar 

  25. Twidale N, Manda V, Nave K, Seal A. Predictors of outcome after radiofrequency catheter ablation of the atrioventricular node for atrial fibrillation and congestive heart failure. Am Heart J1998;136:64–657.

    Google Scholar 

  26. Sager PT. Atrial fibrillation: Antiarrhythmic therapy versus rate control with antithrombotic therapy. Am J Cardiol1997;80:74G-81G.

    Google Scholar 

  27. Petersen P. Thromboembolic complications in atrial fibrillation. Stroke1990;21:–13.

    Google Scholar 

  28. The Stroke Prevention in Atrial Fibrillation Investigators. Predictors of thromboembolism in atrial fibrillation: I. Clinical features of patients at risk. Ann Intern Med 1992;116:–5.

    Google Scholar 

  29. The Stroke Prevention in Atrial Fibrillation Investigators. Predictors of thromboembolism in atrial fibrillation: II. Echocardiographic features of patients at risk. Ann Intern Med1992;116:–12.

    Google Scholar 

  30. Dries DL, Rosenberg YD, Waclawiw MA, Domanski MJ. Ejection fraction and risk of thromboembolic events in patients with systolic dysfunction and sinus rhythm: Evidence for gender differences in the studies of left ventricular dysfunction trials [published erratum appears in J Am Coll Cardiol1998;32(2):555]. J Am Coll Cardiol1997;29:107–1080.

    Google Scholar 

  31. Dunkman WB, Johnson GR, Carson PE, Bhat G, Farrell L, Cohn JN. Incidence of thromboembolic events in congestive heart failure. The V-HeFT VA Cooperative Studies Group. Circulation1993;87:VI9–VI101.

    Google Scholar 

  32. Katz SD, Marantz PR, Biasucci L, et al. Low incidence of stroke in ambulatory patients with heart failure: A prospective study. Am Heart J1993;126:14–146.

    Google Scholar 

  33. Kannel WB, Abbott RD, Savage DD, McNamara PM. Coronary heart disease and atrial fibrillation: The Framingham Study. Am Heart J1983;106:38–396.

    Google Scholar 

  34. Goldberg RJ, Seeley D, Becker RC, et al. Impact of atrial fibrillation on the in-hospital and long-term survival of patients with acute myocardial infarction: A communitywide perspective. Am Heart J1990;119:99–1001.

    Google Scholar 

  35. Waldecker B. Atrial fibrillation in myocardial infarction complicated by heart failure: Cause or consequence? [editorial; comment]. Eur Heart J1999;20:71–712.

    Google Scholar 

  36. Crenshaw BS, Ward SR, Granger CB, Stebbins AL, Topol EJ, Califf RM. Atrial fibrillation in the setting of acute myocardial infarction: The GUSTO-I experience. Global utilization of streptokinase and TPAfor occluded coronary arteries. J Am Coll Cardiol1997;30:40–413.

    Google Scholar 

  37. Pedersen OD, Bagger H, Kober L, Torp-Pedersen C. The occurrence and prognostic significance of atrial fibrillation/-flutter following acute myocardial infarction. TRACE Study Group. TRAndolapril Cardiac Evalution [see comments]. Eur Heart J1999;20:74–754.

    Google Scholar 

  38. Dries DL, Exner DV, Gersh BJ, Domanski MJ, Waclawiw MA, Stevenson LW. Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: A retrospective analysis of the SOLVD trials. Studies of Left Ventricular Dysfunction. J Am Coll Cardiol1998;32:69–703.

    Google Scholar 

  39. Deedwania PC, Singh BN, Ellenbogen K, Fisher S, Fletcher R, Singh SN. Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: Observations from the veterans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF-STAT). The Department of Veterans Affairs CHF-STAT Investigators. Circulation1998;98:257–2579.

    Google Scholar 

  40. Mahoney P, Kimmel S, DeNofrio D, Wahl P, Loh E. Prognostic significance of atrial fibrillation in patients at a tertiary medical center referred for heart transplantation because of severe heart failure.AmJ Cardiol1999;83:154– 1547.

    Google Scholar 

  41. Allessie MA, Lammers WJEP, Smeets JRLM, Bonke FIM, Hollen J. Total mapping of atrial excitation during acetylcholine-induced atrial flutter and fibrillation in the isolated canine heart. In: Kulbertus HE, Olsson SB, Schlepper M, eds. Atrial Fibrillation. Molndal, Sweden: Lindgren and Soner, 1982:4–62.

    Google Scholar 

  42. Peters NS, Coromilas J, Hanna MS, Josephson ME, Costeas C, Wit AL. Characteristics of the temporal and spatial excitable gap in anisotropic reentrant circuits causing sustained ventricular tachycardia. Circ Res 1998;82:27–293.

    Google Scholar 

  43. Hordof AJ, Edie R, Malm JR, Hoffman BF, Rosen MR. Electrophysiologic properties and response to pharmacologic agents of fibers from diseased human atria. Circulation1976;54:77–779.

    Google Scholar 

  44. Gelband H, Rosen MR, Myerburg RJ, Bush HL, Bassett AL, Hoffman BF. Restorative effect of epinephrine on the electrophysiologic properties of depressed human atrial tissue. J Electrocardiol1977;10:31–320.

    Google Scholar 

  45. Ten Eick RE, Singer DH. Electrophysiological properties of diseased human atrium. I. Low diastolic potential and altered cellular response to potassium. Circ Res 1979;44:54–557.

    Google Scholar 

  46. Mary-Rabine L, Albert A, Pham TD, et al. The relationship of human atrial cellular electrophysiology to clinical function and ultrastructure. Circ Res1983;52:18–199.

    Google Scholar 

  47. January CT, Fozzard HA. The effects of membrane potential, extracellular potassium, and tetrodotoxin on the intracellular sodium ion activity of sheep cardiac muscle. Circ Res1984;54:65–665.

    Google Scholar 

  48. Ducceschi V, Di Micco G, Sarubbi B, Russo B, Santangelo L, Iacono A. Ionic mechanisms of ischemia-related ventricular arrhythmias. Clin Cardiol1996;19:32–331.

    Google Scholar 

  49. Le Heuzey JY, Boutjdir M, Gagey S. Cellular aspects of atrial vulnerability. In: Attuel P, Coumel P, Janse MJ, eds. The Atrium in Health and Disease. Mount Kisco, NY: Futura, 1989:8–94.

    Google Scholar 

  50. Attuel P, Childers R, Cauchemez B, Poveda J, Mugica J, Coumel P. Failure in the rate adaptation of the atrial refractory period: Its relationship to vulnerability. Int J Cardiol1982;2:17–197.

    Google Scholar 

  51. Davidenko JM, Antzelevitch C. Electrophysiological mechanisms underlying rate-dependent changes of refractoriness in normal and segmentally depressed canine Purkinje fibers. The characteristics of post-repolarization refractoriness. Circ Res1986;58:25–268.

    Google Scholar 

  52. Lau CP, Tse HF, Ayers GM. Defibrillation-guided radiofrequency ablation of atrial fibrillation secondary to an atrial focus. J Am Coll Cardiol1999;33:121–1226.

    Google Scholar 

  53. Haïssaguerre M, Jaïs P, Shah DC, Arentz T, Kalusche D, Takahashi A, Garrigue S, Hocini M, Peng JT, Clementy J. Catheter ablation of chronic atrial fibrillation targeting the reinitiating triggers. J Cardiovasc Electrophysiol 2000;11:–10.

    Google Scholar 

  54. Chen SA, Hsieh MH, Tai CT, et al. Initiation of atrial fibrillation by ectopic beats originating from the pulmonary veins: Electrophysiological characteristics, pharmacological responses, and effects of radiofrequency ablation [in process citation]. Circulation1999;100:187–1886.

    Google Scholar 

  55. Smith PN, Eaker ED, Vidaillet HJ, Hayes JJ, Sharma PK, Slusser J, Chyou PH. Ectopic atrial tachycardia in the general population: The rhythm that starts the risk. Circulation1999; 100(18 Suppl 1), I-28–I-288.

    Google Scholar 

  56. Vaziri SM, Larson MG, Benjamin EJ, Levy D. Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Heart Study. Circulation1994;89:72– 730.

    Google Scholar 

  57. Pozzoli M, Cioffi G, Traversi E, Pinna GD, Cobelli F, Tavazzi L. Predictors of primary atrial fibrillation and concomitant clinical and hemodynamic changes in patients with chronic heart failure: A prospective study in 344 patients with baseline sinus rhythm. J Am Coll Cardiol1998;32:19–204.

    Google Scholar 

  58. Yamada T, Fukunami M, Shimonagata T, et al. Prediction of paroxysmal atrial fibrillation in patients with congestive heart failure: A prospective study. J Am Coll Cardiol 2000;35:40–413.

    Google Scholar 

  59. Ravelli F, Allessie M. Effects of atrial dilatation on refractory period and vulnerability to atrial fibrillation in the isolated Langendorff-perfused rabbit heart. Circulation1997;96:168–1695.

    Google Scholar 

  60. Kaseda S, Zipes DP. Contraction-excitation feedback in the atria: A cause of changes in refractoriness. J Am Coll Cardiol1988;11:132–1336.

    Google Scholar 

  61. Satoh T, Zipes DP. Unequal atrial stretch in dogs increases dispersion of refractoriness conducive to developing atrial fibrillation. J Cardiovasc Electrophysiol 1996;7:83–842.

    Google Scholar 

  62. Tuinenburg AE, van Veldhuisen DJ, Boomsma F, Van den Berg MP, de Kam PJ, Crijns HJ. Comparison of plasma neurohormones in congestive heart failure patients with atrial fibrillation versus patients with sinus rhythm. Am J Cardiol1998;81:120–1210.

    Google Scholar 

  63. Van den Berg MP, Crijns HJ, van Veldhuisen DJ, Van Gelder IC, de Kam PJ, Lie KI. Atrial natriuretic peptide in patients with heart failure and chronic atrial fibrillation: Role of duration of atrial fibrillation. Am Heart J 1998;135:24–244.

    Google Scholar 

  64. Li D, Fareh S, Leung TK, Nattel S. Promotion of atrial fibrillation by heart failure in dogs: Atrial remodeling of a different sort. Circulation1999;100:8–95.

    Google Scholar 

  65. Boyden PA, Tilley LP, Pham TD, Liu SK, Fenoglic JJ, Jr., Wit AL. Effects of left atrial enlargement on atrial transmembrane potentials and structure in dogs with mitral valve fibrosis. Am J Cardiol1982;49:189–1908.

    Google Scholar 

  66. Boyden PA, Tilley LP, Albala A, Liu SK, Fenoglio JJ, Jr., Wit AL. Mechanisms for atrial arrhythmias associated with cardiomyopathy: A study of feline hearts with primary myocardial disease. Circulation1984;69:103– 1047.

    Google Scholar 

  67. Spach MS, Dolber PC. Relating extracellular potentials and their derivatives to anisotropic propagation at a microscopic level in human cardiac muscle. Evidence for electrical uncoupling of side-to-side fiber connections with increasing age. Circ Res 1986;58:35–371.

    Google Scholar 

  68. Escande D, Coraboeuf E, Planche C. Abnormal pacemaking is modulated by sarcoplasmic reticulum in partiallydepolarized myocardium from dilated right atria in humans. J Mol Cell Cardiol1987;19:23–241.

    Google Scholar 

  69. Riemer TL, Sobie EA, Tung L. Stretch-induced changes in arrhythmogenesis and excitability in experimentally based heart cell models. Am J Physiol1998;275:H43– H442.

    Google Scholar 

  70. Nakagawa H, Chandrasekaran K, Waiter MG, Mangla V, China N, Matsudaira K, Monir G, Shah N, Spector PS, Beckman KJ, Lazzara R, Jackman WM. Anatomical substrate in focal atrial fibrillation. Circulation1999; 100(18 Suppl I).

  71. Brand FN, Abbott RD, Kannel WB, Wolf PA. Characteristics and prognosis of lone atrial fibrillation. 3–year follow-up in the Framingham Study. JAMA 1985;254:344–3453.

    Google Scholar 

  72. Kopecky SL, Gersh BJ, McGoon MD, et al. The natural history of lone atrial fibrillation. A population-based study over three decades. N Engl J Med1987;317:66– 674.

    Google Scholar 

  73. Scardi S, Mazzone C, Pandullo C, Goldstein D, Poletti A, Humar F. Lone atrial fibrillation: Prognostic differences between paroxysmal and chronic forms after 10 years of follow-up [see comments]. Am Heart J1999;137:68–691.

    Google Scholar 

  74. Hobbs WJ, Van Gelder IC, Fitzpatrick AP, Crijns HJ, Garratt CJ. The role of atrial electrical remodeling in the progression of focal atrial ectopy to persistent atrial fibrillation. J Cardiovasc Electrophysiol1999;10:86–870.

    Google Scholar 

  75. Falk RH, Podrid PJ. Atrial Fibrillation: Mechanisms and Management, 2nd edn. Philadelphia: Lippincott-Raven Publishers, 1997.

    Google Scholar 

  76. Tieleman RG, Van Gelder IC, Crijns HJ, et al. Early recurrences of atrial fibrillation after electrical cardioversion: Aresult of fibrillation-induced electrical remodeling of the atria? J Am Coll Cardiol1998;31:16–173.

    Google Scholar 

  77. Timmermans C, Wellens HJ. Effect of device-mediated therapy on symptomatic episodes of atrial fibrillation. J Am Coll Cardiol1998; 31(A):331A–331A.

    Google Scholar 

  78. Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation 1995;92:195–1968.

    Google Scholar 

  79. Van Wagoner DR, Pond AL, McCarthy PM, Trimmer JS, Nerbonne JM. Outward K+ current densities and Kv1.5 expression are reduced in chronic human atrial fibrillation. Circ Res1997;80:77–781.

    Google Scholar 

  80. Yue L, Feng J, Gaspo R, Li GR, Wang Z, Nattel S. Ionic remodeling underlying action potential changes in a canine model of atrial fibrillation. Circ Res1997;81:51–525.

    Google Scholar 

  81. Lai LP, Su MJ, Lin JL, et al. Down-regulation of L-type calcium channel and sarcoplasmic reticular Ca(2+)-ATPase mRNA in human atrial fibrillation without significant change in the mRNA of ryanodine receptor, calsequestrin and phospholamban: An insight into the mechanism of atrial electrical remodeling. J Am Coll Cardiol1999;33:123–1237.

    Google Scholar 

  82. Tieleman RG, Blaauw Y, Van Gelder IC, et al. Digoxin delays recovery from tachycardia-induced electrical remodeling of the atria [in process citation]. Circulation 1999;100:183–1842.

    Google Scholar 

  83. Morillo CA, Klein GJ, Jones DL, Guiraudon CM. Chronic rapid atrial pacing. Structural, functional, and electrophysiological characteristics of a new model of sustained atrial fibrillation. Circulation1995;91:158–1595.

    Google Scholar 

  84. Garratt CJ, Duytschaever M, Killian M, Dorland R, Mast F, Allessie MA. Repetitive electrical remodeling by paroxysms of atrial fibrillation in the goat: No cumulative effect on inducibility or stability of atrial fibrillation [see comments]. J Cardiovasc Electrophysiol1999;10:110– 1108.

    Google Scholar 

  85. Langberg JJ. “Atrial fibrillopathy”: Is atrial fibrillation really self-perpetuating? J Cardiovasc Electrophysiol 1999;10:110–1111.

    Google Scholar 

  86. Pandozi C, Bianconi L, Villani M, et al. Electrophysiological characteristics of the human atria after cardioversion of persistent atrial fibrillation. Circulation1998;98:286– 2865.

    Google Scholar 

  87. Daoud EG, Knight BP, Weiss R, et al. Effect of verapamil and procainamide on atrial fibrillation-induced electrical remodeling in humans. Circulation1997;96:154–1550.

    Google Scholar 

  88. Ausma J, Wijffels M, Thone F, Wouters L, Allessie M, Borgers M. Structural changes of atrial myocardium due to sustained atrial fibrillation in the goat. Circulation 1997;96:315–3163.

    Google Scholar 

  89. Jolly WA, Ritchie WJ. Auricular flutter and fibrillation. Heart1911;2:17–221.

    Google Scholar 

  90. Lewis T, Drury AN, Iliescu CC. A demonstration of circus movement in clinical flutter of the auricles. Heart 1921;8:34–359.

    Google Scholar 

  91. Friedman PA, Luria D, Fenton AM, et al. Global right atrial mapping of human atrial flutter: The presence of posteromedial (sinus venosa region) functional block and double potentials: A study in biplane fluoroscopy and intracardiac echocardiography. Circulation2000;101:156– 1577.

    Google Scholar 

  92. Olgin JE, Kalman JM, Lesh MD. Conduction barriers in human atrial flutter: Correlation of electrophysiology and anatomy. J Cardiovasc Electrophysiol1996;7:111–1126.

    Google Scholar 

  93. Nakagawa H, Lazzara R, Khastgir T, et al. Role of the tricuspid annulus and the eustachian valve/ridge on atrial flutter. Relevance to catheter ablation of the septal isthmus and a new technique for rapid identification of ablation success [see comments]. Circulation1996; 94:40–424.

    Google Scholar 

  94. Shah DC, Jais P, Haissaguerre M, et al. Threedimensional mapping of the common atrial flutter circuit in the right atrium. Circulation1997;96:390–3912.

    Google Scholar 

  95. Shimizu A, Nozaki A, Rudy Y, Waldo AL. Onset of induced atrial flutter in the canine pericarditis model [see comments]. J Am Coll Cardiol1991;17:122–1234.

    Google Scholar 

  96. Waldo AI, Cooper TB. Spontaneous onset of type I atrial flutter in patients. J Am Coll Cardiol1996;28:70–712.

    Google Scholar 

  97. Waldo AL. Pathogenesis of atrial flutter. J Cardiovasc Electrophysiol1998;9:S1–S25.

    Google Scholar 

  98. Boyden PA, Hoffman BF. The effects on atrial electrophysiology and structure of surgically induced right atrial enlargement in dogs. Circ Res1981;49:131–1331.

    Google Scholar 

  99. Cox JL, Canavan TE, Schuessler RB, et al. The surgical treatment of atrial fibrillation. II. Intraoperative electrophysiologic mapping and description of the electrophysiologic basis of atrial flutter and atrial fibrillation. J Thorac Cardiovasc Surg1991;101:40–426.

    Google Scholar 

  100. Chen YJ, Chen SA, Tai CT, et al. Electrophysiologic characteristics of a dilated atrium in patients with paroxysmal atrial fibrillation and atrial flutter. J Interv Card Electrophysiol 1998;2:18–186.

    Google Scholar 

  101. Leitch JW, Thomson D, Baird DK, Harris PJ. The importance of age as a predictor of atrial fibrillation and flutter after coronary artery bypass grafting. J Thorac Cardiovasc Surg1990;100:33–342.

    Google Scholar 

  102. Natale A, Breeding L, Tomassoni G, et al. Ablation of right and left ectopic atrial tachycardias using a three-dimensional nonfluoroscopic mapping system. Am J Cardiol1998;82:98–992.

    Google Scholar 

  103. Kalman JM, Olgin JE, Karch MR, Hamdan M, Lee RJ, Lesh MD. “Cristal tachycardias”: Origin of right atrial tachycardias from the crista terminalis identified by intracardiac echocardiography. J Am Coll Cardiol 1998;31:45–459.

    Google Scholar 

  104. Solti F, Vecsey T, Kekesi V. Effect of atrial dilatation on the tendency of atrial arrhythmias. Acta Physiol Hung 1989;74:4–55.

    Google Scholar 

  105. Spach MS, Dolber PC, Heidlage JF. Influence of the passive anisotropic properties on directional differences in propagation following modification of the sodium conductance in human atrial muscle. A model of reentry based on anisotropic discontinuous propagation. Circ Res 1988;62:81–832.

    Google Scholar 

  106. Shine KI, Kastor JA, Yurchak PM. Multifocal atrial tachycardia. Clinical and electrocardiographic features in 32 patients. N Engl J Med1968;279:34–349.

    Google Scholar 

  107. McCord J, Borzak S. Multifocal atrial tachycardia. Chest 1998;113:20–209.

    Google Scholar 

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  1. Vias Markides
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Markides, V., Peters, N.S. Mechanisms Underlying the Development of Atrial Arrhythmias in Heart Failure. Heart Fail Rev 7, 243–253 (2002). https://doi.org/10.1023/A:1020077206796

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