| Focal origin of atrial tachycardia in dogs with rapid ventricular pacing-induced heart failure. | |
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MedLine Citation:
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PMID: 14521664 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Mapping and Ablation of Atrial Tachycardia in Heart Failure. INTRODUCTION: Dogs with rapid ventricular pacing-induced congestive heart failure (CHF) have inducible atrial tachycardia (AT), with a mechanism consistent with delayed afterdepolarization-mediated triggered activity. We assessed the hypothesis that AT has a focal origin. METHODS AND RESULTS: Twenty-one CHF dogs undergoing 3 to 4 weeks of ventricular pacing at 235 beats/min were studied. Biatrial epicardial mapping of 20 sustained AT episodes (cycle length [CL], 175 +/- 53 msec) in 5 dogs revealed an area of earliest activation in the right atrial (RA) free wall (13 episodes), RA appendage (4 episodes), or between the pulmonary veins (3 episodes). Total epicardial activation time during AT (73 +/- 19 msec) was similar to that during sinus rhythm (72 +/- 13 msec) and on average was <50% of the AT CL. Higher-density mapping of the RA free wall during 30 sustained AT episodes (163 +/- 55 msec) in 9 dogs identified a site of earliest activation along the sulcus terminalis most frequently as a stable, focal activation pattern from a single site. Endocardial mapping of 49 sustained AT episodes (156 +/- 27 msec) in 10 dogs revealed multiple sites of AT origin arising along the crista terminalis and pulmonary veins. Right and left ATs were terminated with discrete radiofrequency ablation, but other ATs remained inducible. A rapid, left AT generating an ECG pattern of atrial fibrillation was ablated inside the pulmonary vein. CONCLUSION: AT induced in this CHF model after 3 to 4 weeks of rapid ventricular pacing has an activation pattern consistent with a focal origin. Sites of earliest activation are distributed predominately along the crista terminalis and within or near the pulmonary veins. |
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Authors:
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Guilherme Fenelon; Richard K Shepard; Bruce S Stambler |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 14 ISSN: 1045-3873 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2003 Oct |
Date Detail:
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Created Date: 2003-10-02 Completed Date: 2004-04-13 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1093-102 Citation Subset: IM |
Affiliation:
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Department of Medicine, West Roxbury Veterans Affairs Medical Center, Harvard Medical School, West Roxbury, Massachusetts, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Body Surface Potential Mapping / methods* Cardiac Pacing, Artificial / methods* Catheter Ablation Dogs Heart Atria / physiopathology*, surgery Heart Conduction System / physiopathology* Heart Failure / etiology, physiopathology*, surgery Pericardium / physiopathology Tachycardia, Ectopic Atrial / etiology, physiopathology*, surgery Tachycardia, Ventricular / complications, physiopathology*, surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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