Htet W Khine1, Katarina Steding-Ehrenborg2,3, Jeffrey L Hastings4,5, Jamie Kowal6, James D Daniels4, Richard L Page7, Jeffery J Goldberger8, Jason Ng9, Beverley Adams-Huet4, Michael W Bungo10, Benjamin D Levine11,12. 1. Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego Health (H.W.K.). 2. Division of Physiotherapy, Department of Health Sciences (K.S.-E.). 3. and Cardiac MR Group, Department of Clinical Sciences, Skåne University Hospital (K.S.-E.). 4. Lund University, Sweden. Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (J.L.H., J.D.D., B.A.-H., B.D.L.). 5. Department of Cardiology, VA North Texas Health Care System, Dallas (J.L.H.). 6. Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (J.K.). 7. Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (R.L.P.). 8. Cardiovascular Division, Department of Internal Medicine, University of Miami, FL (J.J.G.). 9. University of Illinois College of Medicine, Chicago (J.N.). 10. Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center, Houston (M.W.B.). 11. Lund University, Sweden. Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (J.L.H., J.D.D., B.A.-H., B.D.L.). benjaminlevine@texashealth.org. 12. Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, TX (B.D.L.).
Abstract
BACKGROUND: The prevalence of atrial fibrillation (AF) in active astronauts is ≈5%, similar to the general population but at a younger age. Risk factors for AF include left atrial enlargement, increased number of premature atrial complexes, and certain parameters on signal-averaged electrocardiography, such as P-wave duration, root mean square voltage for the terminal 20 ms of the signal-averaged P wave, and P-wave amplitude. We aimed to evaluate changes in atrial structure, supraventricular beats, and atrial electrophysiology to determine whether spaceflight could increase the risk of AF. METHODS: Thirteen astronauts underwent cardiac magnetic resonance imaging to assess atrial structure and function before and after 6 months in space and high-resolution Holter monitoring for multiple 48-hour time periods before flight, during flight, and on landing day. RESULTS: Left atrial volume transiently increased after 6 months in space (12±18 mL; P=0.03) without changing atrial function. Right atrial size remained unchanged. No changes in supraventricular beats were noted. One astronaut had a large increase in supraventricular ectopic beats but none developed AF. Filtered P-wave duration did not change over time, but root mean square voltage for the terminal 20 ms decreased on all fight days except landing day. No changes in P-wave amplitude were seen in leads II or V1 except landing day for lead V1. CONCLUSIONS: Six months of spaceflight may be sufficient to cause transient changes in left atrial structure and atrial electrophysiology that increase the risk of AF. However, there was no definite evidence of increased supraventricular arrhythmias and no identified episodes of AF.
BACKGROUND: The prevalence of atrial fibrillation (AF) in active astronauts is ≈5%, similar to the general population but at a younger age. Risk factors for AF include left atrial enlargement, increased number of premature atrial complexes, and certain parameters on signal-averaged electrocardiography, such as P-wave duration, root mean square voltage for the terminal 20 ms of the signal-averaged P wave, and P-wave amplitude. We aimed to evaluate changes in atrial structure, supraventricular beats, and atrial electrophysiology to determine whether spaceflight could increase the risk of AF. METHODS: Thirteen astronauts underwent cardiac magnetic resonance imaging to assess atrial structure and function before and after 6 months in space and high-resolution Holter monitoring for multiple 48-hour time periods before flight, during flight, and on landing day. RESULTS: Left atrial volume transiently increased after 6 months in space (12±18 mL; P=0.03) without changing atrial function. Right atrial size remained unchanged. No changes in supraventricular beats were noted. One astronaut had a large increase in supraventricular ectopic beats but none developed AF. Filtered P-wave duration did not change over time, but root mean square voltage for the terminal 20 ms decreased on all fight days except landing day. No changes in P-wave amplitude were seen in leads II or V1 except landing day for lead V1. CONCLUSIONS: Six months of spaceflight may be sufficient to cause transient changes in left atrial structure and atrial electrophysiology that increase the risk of AF. However, there was no definite evidence of increased supraventricular arrhythmias and no identified episodes of AF.
Authors: Carolina L Zilli Vieira; Mark S Link; Eric Garshick; Adjani A Peralta; Heike Luttmann-Gibson; Francine Laden; Man Liu; Diane R Gold; Petros Koutrakis Journal: Europace Date: 2022-05-03 Impact factor: 5.486
Authors: Eric T Hedge; Courtney A Patterson; Carmelo J Mastrandrea; Vita Sonjak; Guy Hajj-Boutros; Andréa Faust; José A Morais; Richard L Hughson Journal: Front Physiol Date: 2022-08-09 Impact factor: 4.755