ArticleCirculation. Arrhythmia and electrophysiology2011
Abnormal response of superior sinoatrial node to sympathetic stimulation is a characteristic finding in patients with atrial fibrillation and symptomatic bradycardia.
Article in Circulation. Arrhythmia and electrophysiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 33 citations in OpenAlex.
- Chronic amiodarone therapy impairs the function of the superior sinoatrial node in patients with atrial fibrillation.Circulation journal : official journal of the Japanese Circulation Society · 2013Trial
- Inferior Sino-Atrial Node Exit Sites Are Associated With Electrical Remodeling.JACC. Clinical electrophysiology · 2026Article
- Sympathetic toggled sinus rate acceleration as a mechanism of sustained sinus tachycardia in chronic orthostatic intolerance syndrome.Heart rhythm · 2022Article
- Three-dimensional electroanatomic mapping characteristics of superior vena cava myocardial sleeve and sinoatrial node in patients with atrial fibrillation.Frontiers in cardiovascular medicine · 2022Article
- Respiratory variability of sinus node activation in humans: insights from ultra-high-density mapping.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- Recording Intrinsic Nerve Activity at the Sinoatrial Node in Normal Dogs With High-Density Mapping.Circulation. Arrhythmia and electrophysiology · 2021Article
- Isoproterenol-dependent acute reconnection following superior vena cava isolation: Pitfalls of a novel approach using spontaneous conduction block.HeartRhythm case reports · 2020Article
- Article
- Natriuretic Peptide Receptor-C Protects Against Angiotensin II-Mediated Sinoatrial Node Disease in Mice.JACC. Basic to translational science · 2018Article
- TBX18 overexpression enhances pacemaker function in a rat subsidiary atrial pacemaker model of sick sinus syndrome.The Journal of physiology · 2018Article
- Atrial fibrillation and conduction system disease: the roles of catheter ablation and permanent pacing.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2018Review
- Redundant and diverse intranodal pacemakers and conduction pathways protect the human sinoatrial node from failure.Science translational medicine · 2017Article
- Skin sympathetic nerve activity precedes the onset and termination of paroxysmal atrial tachycardia and fibrillation.Heart rhythm · 2017Article
- Biology of the Sinus Node and its Disease.Arrhythmia & electrophysiology review · 2015Article
- Function and dysfunction of human sinoatrial node.Korean circulation journal · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundWe hypothesized that unresponsiveness of superior sinoatrial node (SAN) to sympathetic stimulation is strongly associated with the development of symptomatic bradycardia in patients with atrial fibrillation (AF). METHODS AND
resultsWe performed 3D endocardial mapping in healthy controls (group 1, n=10) and patients with AF without (group 2, n=57) or with (group 3, n=15) symptomatic bradycardia at baseline and during isoproterenol infusion. Corrected SAN recovery time was abnormal in 0%, 11%, and 36% of groups 1, 2, and 3, respectively (P=0.02). At baseline, 90%, 26%, and 7% (P<0.001) of the patients had multicentric SAN activation patterns. For groups 1, 2, and 3, the median distance from the superior vena cava-right atrial junction to the most cranial earliest activation site (EAS) was 5.0 (25-75 percentile range, 3.5-21.3), 10.0 (4-20), and 17.5 (12-34) mm at baseline (P=0.01), respectively, and 4.0 (0-5), 5.0 (1-10), and 15.0 (5.4-33.3) mm, respectively, during isoproterenol infusion (P=0.01), suggesting an upward shift of EAS during isoproterenol infusion. However, although the EAS during isoproterenol infusion was at the upper one third of the crista terminalis in 100% of group 1 and 78% of group 2 patients, only 20% of group 3 patients showed a move of the EAS to that region (P<0.001).
conclusionsSuperior SAN serves as the EAS during sympathetic stimulation in patients without AF and in most patients with AF without symptomatic bradycardia. In contrast, unresponsiveness of superior SAN to sympathetic stimulation is a characteristic finding in patients with AF and symptomatic bradycardia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.