{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:57:34Z","timestamp":1793408254470,"version":"4.5.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2000,3,14]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014Although atrial electrical remodeling has been studied extensively in animal models, the reversibility of this phenomenon after termination of clinical atrial fibrillation (AF) has not been demonstrated. We aimed to examine this important question of reversibility by using AF cycle length (AFCL) and coupling intervals of atrial premature beats after cardioversion as measures of atrial refractoriness.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    \u2014We measured AFCL at the right atrial appendage and distal coronary sinus before attempting internal cardioversion in 39 patients with persistent AF. Patients were monitored by daily transtelephonic recordings after discharge and admitted rapidly for repeat internal cardioversion if there was spontaneous AF recurrence. Measurements of AFCL were repeated immediately before repeat cardioversions in the 17 patients who had recurrence of AF. There was an increase in AFCL from the initial cardioversion to that measured at the time of first AF recurrence at both the right atrial appendage (161\u00b122 vs 167\u00b126 ms,\n                    <jats:italic>P<\/jats:italic>\n                    =0.05) and distal coronary sinus (162\u00b120 vs 168\u00b122 ms,\n                    <jats:italic>P<\/jats:italic>\n                    =0.01) sites. The magnitude of increase in AFCL was positively correlated with duration of sinus rhythm before AF recurrence (\n                    <jats:italic>r=<\/jats:italic>\n                    0.524,\n                    <jats:italic>P<\/jats:italic>\n                    =0.001). Other measures of refractoriness (shortest coupling interval of atrial premature beats and directly measured refractory periods after cardioversion) also increased from initial to subsequent cardioversions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    \u2014These findings demonstrate that changes in atrial electrophysiology associated with chronic AF in humans are reversible after cardioversion and that the extent of this reversal is dependent on the duration of sinus rhythm after cardioversion.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.101.10.1145","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:42:29Z","timestamp":1339447349000},"page":"1145-1151","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":77,"title":["Reversal of Atrial Electrical Remodeling After Cardioversion of Persistent Atrial Fibrillation in Humans"],"prefix":"10.1161","volume":"101","author":[{"given":"W. Julian C.","family":"Hobbs","sequence":"first","affiliation":[{"name":"From the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Fynn","sequence":"additional","affiliation":[{"name":"From the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derick M.","family":"Todd","sequence":"additional","affiliation":[{"name":"From the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wolfson","sequence":"additional","affiliation":[{"name":"From the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Galloway","sequence":"additional","affiliation":[{"name":"From the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford J.","family":"Garratt","sequence":"additional","affiliation":[{"name":"From the Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","unstructured":"Godtfredsen J. Atrial fibrillation: course and prognosis: a follow up study of 1212 cases. In: Kulbertus ZHE Olsson SB Schlepper M eds. Atrial Fibrillation. Molndal Sweden: AB Hassell; 1982:134\u2013135."},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.92.7.1954"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.91.5.1588"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.94.11.2953"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.94.11.2968"},{"key":"e_1_3_2_6_2","first-page":"183","volume":"140","year":"1962","unstructured":"Moe GK. On the multiple wavelet hypothesis of atrial fibrillation. Arch Int Pharmacodyn Ther. 1962;140:183\u2013188.","journal-title":". 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