Evidence map›Paper›PMID 34950292›Full record

ArticleJournal of atrial fibrillation2020

The Arrhythmic Substrate for Atrial Fibrillation in Patients with Mitral Regurgitation.

Matthew R Schill, Phillip S Cuculich, Christopher M Andrews, Ramya Vijayakumar, Chawannuch Ruaengsri, Matthew C Henn, Timothy S Lancaster, Spencer J Melby, Richard B Schuessler, Yoram Rudy and 1 more

Abstract read
In one paragraph

Article in Journal of atrial fibrillation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact, top 66% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 0 citations in OpenAlex.

  1. Article
  2. Electrocardiographic imaging in the atria.Medical & biological engineering & computing · 2023
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 2 countries.

Matthew R SchillDepartment of Surgery, Division of Cardiothoracic Surgery, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8234, St. Louis, MO 63110, USA.
Phillip S CuculichDepartment of Medicine, Cardiovascular Division, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8086, St. Louis, MO 63110, USA.
Christopher M AndrewsDepartment of Biomedical Engineering, Washington University in St. Louis; 1 Brookings Dr., Campus Box 1097, St. Louis MO 63130, USA.
Ramya VijayakumarDepartment of Biomedical Engineering, Washington University in St. Louis; 1 Brookings Dr., Campus Box 1097, St. Louis MO 63130, USA.
Chawannuch RuaengsriDepartment of Surgery, Division of Cardiothoracic Surgery, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8234, St. Louis, MO 63110, USA.
Matthew C HennDepartment of Surgery, Division of Cardiothoracic Surgery, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8234, St. Louis, MO 63110, USA.
Timothy S LancasterDepartment of Surgery, Division of Cardiothoracic Surgery, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8234, St. Louis, MO 63110, USA.
Spencer J MelbyDepartment of Surgery, Division of Cardiothoracic Surgery, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8234, St. Louis, MO 63110, USA.
Richard B SchuesslerDepartment of Surgery, Division of Cardiothoracic Surgery, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8234, St. Louis, MO 63110, USA.
Yoram RudyDepartment of Medicine, Cardiovascular Division, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8086, St. Louis, MO 63110, USA.
Ralph J DamianoDepartment of Surgery, Division of Cardiothoracic Surgery, Washington University in St. Louis; 660 S. Euclid Ave., Campus Box 8234, St. Louis, MO 63110, USA.
Washington University in St. Louis · USInstitute of Cardiology · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePatients with severe mitral regurgitation commonly develop atrial fibrillation. The precise mechanisms of this relationship remain unknown. The objective of this study was to apply noninvasive electrocardiographic imaging of the atria during sinus rhythm to identify changes in atrial electrophysiology that may contribute to development of atrial fibrillation in patients with severe mitral regurgitation referred for mitral valve surgery.

methodsTwenty subjects (9 atrial fibrillation and mitral regurgitation, 11 mitral regurgitation alone) underwent electrocardiographic imaging. Biatrial electrophysiology was imaged with activation maps in sinus rhythm. The reconstructed unipolar electrograms were analyzed for voltage amplitude, number of deflections and conduction heterogeneity. In subjects with mitral regurgitation, left atrial biopsies were obtained at the time of surgery. Results: Subjects with history of atrial fibrillation demonstrated prolonged left atrial conduction times (110±25 ms vs. mitral regurgitation alone (85±21), p=0.025); right atrial conduction times were unaffected. Variable patterns of conduction slowing were imaged in the left atria of most subjects, but those with prior history of atrial fibrillation had more complex patterns of conduction slowing or unidirectional block. The presence of atrial fibrillation was not associated with the extent of fibrosis in atrial biopsies.

conclusionsDetailed changes in sinus rhythm atrial electrophysiology can be imaged noninvasively and can be used to assess the impact and evolution of atrial fibrillation on atrial conduction properties in patients with mitral regurgitation. If replicated in larger studies, electrocardiographic imaging may identify patients with mitral regurgitation at risk for atrial fibrillation and could be used to guide treatment strategies.

Indexed as

Atrial FibrillationElectrocardiographic ImagingInferior Vena Cava

Identifiers

PMID34950292
PMCPMC8691304
OpenAlexW3175780142

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.