Remodeling of Sinus Node Function Produced by Supraventricular Tachyarrhythmias: What Are the Clinical Implications?
The association of atrial fibrillation (AF) with sinus node dysfunction has been known for many years [1–4]. These abnormal atrial electrophysiological features may result from the same organic substrate [1–4]. A considerable body of experimental and human studies in the past 5 years have shown shortening of atrial refractoriness and repolarization and abnormal adaptation to rate as well as conduction slowing as a result of rapid atrial rates of certain duration. These changes are referred as atrial electrical remodeling [5–11]. Short-term rapid atrial rates induce these alterations in atrial electrophysiology via functional changes in ion channels and transporters. However, longer periods of atrial tachycardia result in changes in specific ionic current densities (ICa INa) due to modified expression of the genes that determine the function of the responsible ionic channels [12–16].
KeywordsAtrial Fibrillation Sinus Node Chronic Atrial Fibrillation Sick Sinus Syndrome Sinus Node Dysfunction
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