{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:35:41Z","timestamp":1791012941359,"version":"4.1.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"25","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1998,12,22]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014In animal models, induced atrial fibrillation shortens the atrial effective refractory period (ERP) and reverses its physiological adaptation to rate. It is not clear whether this process, known as \u201celectrical remodeling,\u201d occurs in humans.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014We determined the ERPs, at 5 pacing cycle lengths (300 to 700 ms) and in 5 right atrial sites, after internal cardioversion of chronic atrial fibrillation in 25 patients (14 in pharmacological washout and 11 on amiodarone). The ERPs were 195.5\u00b118.8 ms in the washout and 206.3\u00b117.9 ms in the amiodarone patients (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001). ERPs were closely correlated with the stimulation rates (\n            <jats:italic>r<\/jats:italic>\n            =0.95 in the washout and\n            <jats:italic>r<\/jats:italic>\n            =0.94 in the amiodarone group), and slope values indicating a normal (\u22650.07) or nearly normal (0.05 to 0.06) adaptation of ERP to rate were found in 77% of the 84 paced sites. The mean ERP was shorter in the lateral wall (198.1\u00b117.9 ms) than in the atrial roof (203.3\u00b121.5 ms) and in the septum (210.5\u00b120.0 ms) (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.03). After 4 weeks of sinus rhythm, the mean ERP, determined again in 8 patients (4 in wash-out and 4 on amiodarone), was significantly increased compared with the basal study (221.4\u00b121.4 versus 197.8\u00b118.3 ms,\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014After cardioversion of chronic atrial fibrillation, (1) atrial ERP adaptation to rate was normal or nearly normal in the majority of the cases, (2) a significant dispersion of refractoriness between different right atrial sites was present, and (3) ERPs were significantly increased after 4 weeks of sinus rhythm in both washout and amiodarone patients.\n          <\/jats:p>","DOI":"10.1161\/01.cir.98.25.2860","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:41:02Z","timestamp":1339461662000},"page":"2860-2865","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Electrophysiological Characteristics of the Human Atria After Cardioversion of Persistent Atrial Fibrillation"],"prefix":"10.1161","volume":"98","author":[{"given":"Claudio","family":"Pandozi","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leopoldo","family":"Bianconi","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Villani","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Gentilucci","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Castro","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliano","family":"Altamura","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna P.","family":"Jesi","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Lamberti","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Ammirati","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Santini","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, San Filippo Neri Hospital, Arrhythmia Control Unit (M.V.), La Sapienza University, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","first-page":"183","volume":"140","year":"1962","unstructured":"Moe GK. 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Mount Kisco NY: Futura Publishing Co; 1987:67\u201382."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.58.1.3943157"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.62.2.395"},{"key":"e_1_3_1_6_2","doi-asserted-by":"crossref","unstructured":"Allessie MA Wijffels MCEF Kirchhof CJHI. Experimental models of arrhythmias: toys or truth? 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