We thank Dr Martignani et al. for their interest in our work. We totally agree that the drop of ANP level at Day 1 after ablation is probably the consequence of acute atrial damage caused by radiofrequency (RF). An acute atrial endocrine stunning was previously reported with surgical AF ablation. However, in our study, it reverses within 3 days with concomitant elimination of fluid overload. Bu...

AIMS This study evaluates a simple echocardiographic rhythm independent expression of left atrial (LA) function, 'the left atrial function index' (LAFI). BACKGROUND Quantitation of LA function is challenging and often established parameters including peak A are limited to sinus rhythm (SR). We hypothesized that atrial function could be characterized independent of rhythm by combining analogue...

D irect current electrical cardioversion (DEC) for persistent atrial fibrillation (AF) carries a very high initial success rate of up to 95%, but as few as 23% of patients remain in sinus rhythm one year post-procedure, with most recurrences of AF occurring within the first five days. Amiodarone has emerged as the most effective agent at preventing relapse of AF post-DEC, with up to 69% of pati...

BACKGROUND The AFFIRM (Atrial Fibrillation Follow-Up Investigation of Rhythm Management) trial demonstrated that rate control and rhythm control strategies result in similar survival and quality of life for patients with atrial fibrillation (AF). Because of superior safety and lower cost, rate control is now the recommended strategy for the management of most elderly, high-risk AF patients. O...

During a redo procedure for paroxysmal atrial fibrillation (AF) recurrence, mitral isthmus-dependent atrial tachycardia due to a gap in the previous line and rate-dependent slow conduction in sinus rhythm were demonstrated. After initial achievement of mitral isthmus block, adenosine reproducibly triggered conduction recovery and initiated AF. Further ablation led to AF termination and stable b...

Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in th...

BACKGROUND Patients with sinus node dysfunction (SND) have increased risk of atrial tachyarrhythmias, including atrial fibrillation (AF). To date, treatment patterns and outcomes of patients with SND and AF have not been well described. HYPOTHESIS Patients with SND and AF have higher risk of adverse cardiovascular outcomes. METHODS Sinus node dysfunction was defined clinically, based on tre...

The thoracic vein hypothesis of chronic atrial fibrillation (AF) posits that rapid, repetitive activations from muscle sleeves within thoracic veins underlie the mechanism of sustained AF. If this is so, thoracic vein ablation should terminate sustained AF and prevent its reinduction. Six female mongrel dogs underwent chronic pulmonary vein (PV) pacing at 20 Hz to induce sustained (>48 h) AF. B...

OBJECTIVE The aim of this study was to evaluate the effect of cardiac rhythm on the echocardiographic mitral valve area (MVA) and transmitral gradient calculation in relation to net atrioventricular compliance (Cn). METHODS Patients (n=22) with mild or moderate pure rheumatic mitral stenosis (MS) (MVA <2 cm2 and MVA >1 cm2) and atrial fibrillation (AF) were evaluated. All patients underwent t...

BACKGROUND We assessed the validity of the atrial electromechanical interval, measured by transthoracic tissue Doppler echocardiography, in determining patients at risk of post-coronary artery bypass graft atrial fibrillation (AF). METHODS AND RESULTS This prospective study recruited 355 patients in sinus rhythm who were candidates for coronary artery bypass grafting. The patients underwent a...