{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T01:08:24Z","timestamp":1780880904797,"version":"3.54.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The significance of endo\u2010epicardial asynchrony (EEA) and atrial conduction block (CB), which play an important role in the pathophysiology of atrial fibrillation (AF) during sinus rhythm is poorly understood. The aim of our study was therefore to examine 3\u2010dimensional activation of the human right atrium (RA).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Eighty patients (79% men, 39% history of AF) underwent simultaneous endo\u2010epicardial sinus rhythm mapping of the inferior, middle and superior RA. Areas of CB were defined as conduction delays of \u226512\u00a0ms, EEA as activation time differences of opposite electrodes of \u226515\u00a0ms and transmural CB as CB at similar endo\u2010epicardial sites. CB was more pronounced at the endocardium (all locations\n              <jats:italic>P<\/jats:italic>\n              &lt;0.025). Amount, extensiveness and severity of CB was higher at the superior RA. Transmural CB at the inferior RA was associated with a higher incidence of post\u2010operative AF (\n              <jats:italic>P<\/jats:italic>\n              =0.03). EEA occurred up to 84\u00a0ms and was more pronounced at the superior RA (superior: 27\u00a0ms [interquartile range, 18.3\u201339.3], versus mid\u2010RA: 20.3\u00a0ms [interquartile range, 0\u201329.9], and inferior RA: 0\u00a0ms [interquartile range, 0\u201321],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Hypertension (\n              <jats:italic>P<\/jats:italic>\n              =0.009), diabetes mellitus (\n              <jats:italic>P<\/jats:italic>\n              =0.018), and hypercholesterolemia (\n              <jats:italic>P<\/jats:italic>\n              =0.015) were associated with a higher degree of EEA. CB (\n              <jats:italic>P<\/jats:italic>\n              =0.007) and EEA (\n              <jats:italic>P<\/jats:italic>\n              =0.037) were more pronounced in patients with a history of persistent AF compared with patients without AF history.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This study provides important insights into complex atrial endo\u2010epicardial excitation. Significant differences in conduction disorders between the endo\u2010 and epicardium and a significant degree of EEA are already present during sinus rhythm and are more pronounced in patients with cardiovascular risk factors or a history of persistent AF.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017069","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T09:05:29Z","timestamp":1597741529000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Simultaneous Endo\u2010Epicardial Mapping of the Human Right Atrium: Unraveling Atrial Excitation"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7671-4542","authenticated-orcid":false,"given":"Rohit K.","family":"Kharbanda","sequence":"first","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Department of Cardiothoracic Surgery Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Knops","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisette J. M. E.","family":"van der Does","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Kik","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannick J. H. J.","family":"Taverne","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten C.","family":"Roos\u2010Serote","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annejet","family":"Heida","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans B. S.","family":"Oei","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6200-1998","authenticated-orcid":false,"given":"Ad J. J. C.","family":"Bogers","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0259-6691","authenticated-orcid":false,"given":"Natasja M. S.","family":"de Groot","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.1.250"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvq336"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003648"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2018.02.020"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00025.2003"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.910901"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.74.5.882"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.005745"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.06.249"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003972"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.05.026"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.08.067"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.21.2771"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1971.220.1.1"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2004.06.010"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.88.4.406"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.03.098"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diff.2012.04.006"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.031542"},{"key":"e_1_3_2_21_2","first-page":"745","article-title":"Proof of endo\u2010epicardial asynchrony of the left atrial wall in humans","volume":"2","author":"Kharbanda RK","year":"2020","unstructured":"Kharbanda RK, Kik C, de Knops P, Bogers AJJC, de Groot NMS. Proof of endo\u2010epicardial asynchrony of the left atrial wall in humans. J Am Coll Cardiol Case Rep. 2020;2:745\u2013749.","journal-title":"J Am Coll Cardiol Case Rep"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.005145"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.7.1954"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00031.2009"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv233"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.10.2649"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000062689.04037.3F"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(00)00026-2"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.09.064"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.555"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.017069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:11:18Z","timestamp":1715598678000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.017069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":29,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1161\/JAHA.120.017069"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.017069","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]},"assertion":[{"value":"2020-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e017069"}}