New manifestations of electrophysiological remodeling of heart during experimental model of atrial fibrillation in cirrhotic rat isolated heart

The present study is aimed to evaluate electrophysiological remodeling of atrioventricular (AV) node and ventricular conduction during experimental atrial fibrillation (AF) model in isolated heart of cirrhotic rats.

Cirrhosis-induced electrophysiological remodeling was evaluated in 24 isolated retrogradely perfused rat hearts in 2 groups (control and cirrhotic). Cirrhosis was induced after 6 weeks of common bile duct ligation in rats. Extracellular filed potential was recorded from upper atrium and right ventricle. The conduction time, refractoriness and frequency-dependent properties of AV node were characterized by specific stimulation protocols. Experimental AF was simulated by high-rate atrial pacing with random coupling intervals (range 75–125 ms).

Nodal conduction time and ventricular responsiveness were significantly increased in the cirrhotic rats compared to the control (95.8 ± 4.2 ms vs. 78.8 ± 3.3 ms) (P< 0.05). Nodal protective function during AF was potentiated with increased R-R interval, concealed beats, ventricular refractoriness and zone of concealment in the cirrhotic group. Cirrhosis evoked rate–dependent ventricular conduction time shortening with different patterns during arrhythmia.

Cirrhosis-induced electrophysiological remodeling was shown by increased AV nodal conduction and shortened ventricular conduction. This electrophysiological remodeling may be considered as a new manifestation of cirrhotic cardiomyopathy in the heart, which can change ventricular rhythm during arrhythmia.