Dynamic nature of atrial fibrillation substrate during development and reversal of heart failure in dogs. Shinagawa, K.; Shi, Y.; Tardif, J.; Leung, T.; and Nattel, S. j-C, 105(22):2672--2678, June, 2002.
  author =       "K. Shinagawa and Y.F. Shi and J.C. Tardif and T.K.
                 Leung and S. Nattel",
  title =        "Dynamic nature of atrial fibrillation substrate during
                 development and reversal of heart failure in dogs.",
  journal =      j-C,
  year =         "2002",
  month =        jun,
  volume =       "105",
  number =       "22",
  pages =        "2672--2678",
  robnote =      "Chronically instrumented dogs were subjected to 4 to 6
                 weeks of ventricular tachypacing (VTP; 220 to 240 bpm)
                 to induce congestive heart failure (CHF), followed by a
                 5-week recovery period leading to hemodynamic
                 normalization at 5-week recovery (Wk5(rec)). The
                 duration of burst pacing-induced AF under
                 ketamine/diazepam/isoflurane anesthesia increased
                 progressively during VTP and recovered toward baseline
                 during the recovery period, paralleling changes in
                 atrial dimensions. However, even at full recovery,
                 sustained AF could still be induced under relatively
                 vagotonic morphine/chloralose anesthesia. Wk5(rec) dogs
                 showed no recovery of CHF-induced atrial fibrosis
                 (3.1+/-0.3\% for controls versus 10.7+/-1.0\% for CHF
                 and 12.0+/-0.8\% for Wk5(rec) dogs) or local conduction
                 abnormalities (conduction heterogeneity index 1.8+/-0.1
                 in controls versus 2.3+/-0.1 in CHF and 2.2+/-0.2 in
                 Wk5(rec) dogs). One week of atrial tachypacing failed
                 to affect the right atrial effective refractory period
                 significantly in CHF dogs but caused highly significant
                 effective refractory period reductions and atrial
                 vulnerability increases in Wk5(rec) dogs. CONCLUSIONS:
                 Reversal of CHF is followed by normalized atrial
                 function and decreased duration of AF; however,
                 fibrosis and conduction abnormalities are not
                 reversible, and a substrate that can support prolonged
                 AF remains. Early intervention to prevent fixed
                 structural abnormalities may be important in patients
                 with conditions that predispose to the arrhythmia.",
  bibdate =      "Sun Jun 1 18:41:50 2008",
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