Document Detail

Both Purkinje cells and left ventricular posteroseptal reentry contribute to the maintenance of ventricular fibrillation in open-chest dogs and swine: effects of catheter ablation and the ventricular cut-and-sew operation.
MedLine Citation:
PMID:  18577833     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Radiofrequency catheter ablation (RFCA) targeting the left ventricular posteroseptum (LVPS) and posterior papillary muscle (PPM) terminates or prevents ventricular fibrillation (VF) in rabbit and dog hearts. However, whether the mechanism of VF maintenance is reentry or focal Purkinje firing is unclear. METHODS AND RESULTS: In the present study the effects of RFCA (endocardial ablation of PPM+LVPS in 7 dogs and 7 swine), left ventricular anterolateral wall ablation (LVAL in 7 dogs), and the cut-and-sew operation (CSO: along the left ventricular posterior wall (LVPW) beside PPM in 7 swine) on VF inducibility were compared. (1) VF inducibility was decreased from 100+/-0% to 21.9+/-31.2% (p<0.0001) by PPM+LVPS endocardial ablation, but not by LVAL ablation in dogs. (2) LVPW CSO reduced VF inducibility (100+/-0% to 43.6+/-9.5%, p<0.0001) in swine. (3) In contrast to the canine Purkinje network, which is mostly localized to the subendocardium, the swine Purkinje network extends to the subepicardial layer with a higher density (p<0.001). CONCLUSION: Both PPM+LVPS ablation (Purkinje destruction) in dogs and LVPW CSO (blocking reentry) in swine reduce VF inducibility, suggesting that in both species focal firing from the Purkinje network and reentry around the PPM contributes to the maintenance of VF.
Hui-Nam Pak; Gwang Il Kim; Hong Euy Lim; Yong Hu Fang; Jong Il Choi; Jin Seok Kim; Chun Hwang; Young-Hoon Kim
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  72     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-25     Completed Date:  2008-09-18     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1185-92     Citation Subset:  IM    
Korea University Cardiovascular Center, Seoul.
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MeSH Terms
Catheter Ablation*
Disease Models, Animal
Endocardium / cytology
Heart Septum / cytology,  physiology,  surgery
Heart Ventricles / cytology,  surgery
Myocardium / cytology
Papillary Muscles / cytology,  physiology,  surgery
Purkinje Fibers / cytology,  physiology*,  surgery*
Species Specificity
Ventricular Fibrillation / physiopathology*,  surgery*
Ventricular Function

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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