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Type: Journal article
Title: Electrophysiologic and electroanatomic changes in the human atrium associated with age
Author: Kistler, P.
Sanders, P.
Fynn, S.
Stevenson, I.
Spence, S.
Vohra, J.
Sparks, P.
Kalman, J.
Citation: Journal of the American College of Cardiology, 2004; 44(1):109-116
Publisher: Elsevier Science Inc
Issue Date: 2004
ISSN: 0735-1097
Statement of
Peter M. Kistler, Prashanthan Sanders, Simon P. Fynn, Irene H. Stevenson, Steven J. Spence, Jitendra K. Vohra, Paul B. Sparks, Jonathan M. Kalman
Abstract: <h4>Objectives</h4>The purpose of this study was to characterize the pattern of atrial remodeling seen with human aging.<h4>Background</h4>Atrial fibrillation (AF) occurs in 3% to 4% of the population over 65 years of age. It is associated with thromboembolic complications, worsening heart failure, and increased mortality, yet the electrical and structural remodeling that occurs with human aging remains unknown.<h4>Methods</h4>Thirteen patients (66.4 +/- 1.7 years) > or =60 years (group A), 13 patients (50 +/- 2.1 years) age 31 to 59 years (group B), and 15 patients (24.7 +/- 1.0 years) < or =30 years (group C) underwent conventional electrophysiologic studies and electroanatomic mapping. We measured atrial refractoriness (ERP) at the distal coronary sinus (CS); low and high lateral right atrium (LRA) and the high septal right atrium at 600, 500, and 400 ms; maximum corrected sinus node recovery time (CSNRT); P-wave duration (PWD); conduction time (CT) along the CS and LRA; and discrete double potentials (DP) along the crista.<h4>Results</h4>Aging was associated with an increase in atrial ERP, prolonged CT along the CS, increased PWD and CSNRT. There was no significant change in dispersion of refractoriness or rate adaptation. Electroanatomic mapping revealed diffuse areas of low voltage with regional conduction slowing. Both techniques demonstrated a greater number of DPs and fractionated signals along the crista terminalis with aging.<h4>Conclusions</h4>Aging is associated with regional conduction slowing, anatomically determined conduction delay at the crista, and structural changes that include areas of low voltage. In addition, impairment of sinus node function and an increase in atrial ERP occurred with aging. This electrical and structural remodeling may explain the increased propensity to AF with aging.
Keywords: Heart Atria; Heart Conduction System; Humans; Atrial Fibrillation; Body Surface Potential Mapping; Electrophysiologic Techniques, Cardiac; Prospective Studies; Age Factors; Aging; Atrial Function; Adult; Aged; Middle Aged; Statistics as Topic
Description: © 2004 by the American College of Cardiology Foundation. Published by Elsevier Inc.
RMID: 0020071867
DOI: 10.1016/j.jacc.2004.03.044
Appears in Collections:Medicine publications

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