Adenosine Plasma Level in Patients with Paroxysmal or Persistent Atrial Fibrillation and Normal Heart during Ablation Procedure and/or Cardioversion - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Purinergic Signalling Année : 2019

Adenosine Plasma Level in Patients with Paroxysmal or Persistent Atrial Fibrillation and Normal Heart during Ablation Procedure and/or Cardioversion

Marion Marlinge
  • Fonction : Auteur
Donato Vairo
Giovanna Mottola
Linda Koutbi
  • Fonction : Auteur
Pierre Deharo
Marguerite Gastaldi
  • Fonction : Auteur
Marine Gaudry
Claire Guiol
  • Fonction : Auteur
Bottone Sara
  • Fonction : Auteur
Patrick Mace
  • Fonction : Auteur
Rosita Guéant
  • Fonction : Auteur
Mohamed Chefrour
  • Fonction : Auteur
Elsa Martinez
  • Fonction : Auteur
Michelet Pierre
  • Fonction : Auteur
Jean-Louis Guéant
Alain Boussuges
  • Fonction : Auteur
Jean Ruf
Emmanuel Fenouillet
Jean Claude Deharo
  • Fonction : Auteur
Régis Guieu
  • Fonction : Auteur
Frederic Franceschi
  • Fonction : Auteur

Résumé

Objectives : The mechanism of atrial fibrillation (AF) in patients with normal heart remains unclear. While exogenous adenosine can trigger AF, nothing is known about the behavior of endogenous adenosine plasma level (APL) at the onset of AF and during ablation procedure. Methods : 91 patients (68 with paroxysmal AF: 40 males, 66±16 years; 23 with persistent AF: 14 males, 69±11 years) and 18 controls were included. Among paroxysmal patients: i) medical therapy alone was performed in 45 cases and ablation procedure in 23. AF was spontaneously resolutive in 6 cases; ii) 23 underwent ablation procedure and blood was collected simultaneously in a brachial vein and in the left atrium; 17 were spontaneously in sinus rhythm while 6 were in sinus rhythm after direct current cardioversion. Among persistent patients: i) in 17 patients, blood samples were collected in a brachial vein before and after direct current cardioversion; ii) in 6 patients, blood samples were collected simultaneously in a brachial vein and in left atrium before and after cardioversion during ablation procedure. Results : CV-APL was higher in patients with persistent AF vs patients with paroxysmal AF (Median[range]:0.9[0.6-1.1]vs0.7[0.4-1.1]µM;p<0.001). In patients with paroxysmal AF, LAAPL increased during the AF episode (0.95[0.85-1.4]vs2.7[1.5-7]µM;p=0.03) and normalized in sinus rhythm after DCCV. In patients with persistent AF, LA-APL was higher than CVAPL (1.2[0.7-1.8]vs 0.9[0.6-1.1]µM; p<0.001), and both normalized in sinus rhythm (CVAPL:0.8[0.6-1.1]vs0.75[0.4-1]µM;p=0.03), (LA-APL:1.95[1.3-3]vs1[0.5-1.15]µM; p=0.03). Conclusion : The occurrence of AF is associated with a strong increase of APL in the atrium. The cause of this increase needs further investigations.
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Dates et versions

hal-02570901 , version 1 (15-05-2020)

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  • HAL Id : hal-02570901 , version 1

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Maille Baptiste, Marion Marlinge, Donato Vairo, Giovanna Mottola, Linda Koutbi, et al.. Adenosine Plasma Level in Patients with Paroxysmal or Persistent Atrial Fibrillation and Normal Heart during Ablation Procedure and/or Cardioversion. Purinergic Signalling, 2019. ⟨hal-02570901⟩

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