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Electrophysiologic and electroanatomic changes in the human atrium associated with age

Peter M. Kistler, MBBS^*, Prashanthan Sanders, MBBS, PhD^*, Simon P. Fynn, MD^*, Irene H. Stevenson, MBBS^*, Steven J. Spence, ACCT^*, Jitendra K. Vohra, MD^*, Paul B. Sparks, MBBS, PhD^* and Jonathan M. Kalman, MBBS, PhD^*,*

^* Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
Department of Medicine, The University of Melbourne, Melbourne, Australia

View larger version (27K): [in a new window]   Figure 1 Coronary sinus node recovery times (CSNRTmax) were significantly longer in group A patients at all cycle lengths. Solid bars = group A; spotted bars = group B; open bars = group C. *p < 0.05 for groups A vs. C.

View larger version (99K): [in a new window]   Figure 2 Electroanatomic bipolar voltage mapping. Color annotation is with bipolar voltages of 0.5 mV shown in red, through to voltages 5 mV shown in purple. CS = coronary sinus; DP = double potentials; FS = fractionated signals; SVC = superior vena cava.

View larger version (17K): [in a new window]   Figure 3 Conduction velocity at all right atrial regions was significantly reduced in both group A and B patients compared with group C. Triangles = group A; circles = group B; diamonds = group C. #p < 0.01; for group A vs. C; p < 0.05 for group B vs. C; p < 0.01 for group B vs. C.

View larger version (23K): [in a new window]   Figure 4 Probability density distribution of surface area plotted against continuous bipolar voltage amplitude. The peak probability distribution occurs at a lower range of bipolar voltage in the group A and B patients with a more uniform voltage between 1 and 3.5 mV in the group C patients.

View larger version (17K): [in a new window]   Figure 5 Electroanatomic voltage mapping according to right atrial regions demonstrating a significant reduction in regional atrial voltage at six of six sites in group A compared with group C and four of six sites in group B vs. C. Triangles = group A; circles = group B; diamonds = group C. *p < 0.05 for group A vs. C; #p < 0.01; for group A vs. C; p < 0.05 for group B vs. C; p < 0.01 for group B vs. C.