Atrial Ischemia Promotes Atrial Fibrillation in Dogs

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Abstract
Background— Coronary artery disease is a significant risk factor for atrial fibrillation (AF), but the basis for this association is incompletely understood. The present study evaluated the hypothesis that atrial ischemia can create a substrate for AF maintenance. Methods and Results— Atrial ischemia was induced by occlusion of an atrial arterial branch that did not provide blood flow to the ventricles. Atrial-arterial occlusion increased the duration of AF induced by burst pacing from 57±32 seconds (control) to 803±214 seconds (PP20 minutes) was induced in 0 of 16 dogs (0%) under control conditions, 7 of 16 (44%, PPPPConclusions— Experimental atrial ischemia creates a substrate for AF maintenance, apparently by causing local conduction slowing that promotes reentry. These results suggest that atrial ischemia may significantly promote AF, and may be relevant to AF mechanisms in association with coronary artery disease.