Document Detail


Neural Mechanism of Atrial Fibrillation: Insight from Global High Density Frequency Mapping.
MedLine Citation:
PMID:  21352394     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Frequency Mapping During Neurally Mediated AF. Background: It has been demonstrated that intrinsic cardiac autonomic activation of ganglionated plexi (GPs) exhibits a frequency gradient from the center to the periphery with limited mapping. Objective: We aimed to use a global mapping tool (Ensite Array) to identify the frequency distribution and clarify the interaction between the extrinsic/intrinsic autonomic systems. Methods: A mid sternal thoractomy was performed in anesthetized dogs. High frequency stimulation (20 Hz, 0.1 ms duration) was applied to locate the GPs and achieve vagosympathetic stimulation (VNS). There were 4 major GPs, which were located near the 4 pulmonary vein (PV) ostia, and a third fat pad (SVC-Ao) GP that was located near the superior vena cava (SVC)-right atrial (RA) junction. Results: Without VNS (n = 12), the left atrial (LA) mean (8.20 ± 0.11 vs 7.95 ± 0.30 Hz, P = 0.04) and max (9.86 ± 0.28 vs 9.43 ± 0.29 Hz, P = 0.03) DFs were higher during the PV ostial GP stimulation than the SVC-Ao GP stimulation. The LA max DFs were located not only at the primary GPs but also the nearby secondary PV ostial GPs. The RA mean DF (8.36 ± 0.05 vs 7.99 ± 0.19 Hz, P = 0.04) was higher during SVC-Ao GP stimulation than PV ostial GP stimulation. The max DF was located inside the SVC during SVC-Ao GP stimulation and at the RA septum during PV ostial GP stimulation. With VNS (n = 12), the LA mean and max DFs between the PV ostial and SVC-Ao GP stimulation were similar. The DF distribution shifted to non-GP LA sites during both the PV ostial and SVC-Ao GP stimulation. Conclusion: The findings indicate that the AF was caused by an interaction between the PV ostial GPs during intrinsic autonomic stimulation, whereas the non-GP LA sites were responsible for the AF induced by an extrinsic neural input. (J Cardiovasc Electrophysiol, Vol. pp. 1-8).
Authors:
Li-Wei Lo; Chuen-Wang Chiou; Yenn-Jiang Lin; Shih-Huang Lee; Shih-Ann Chen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-25
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
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