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学科主题: 临床医学
题名:
An Acute Experimental Model Demonstrating 2 Different Forms of Sustained Atrial Tachyarrhythmias
作者: Niu, Guodong2; Scherlag, Benjamin J.1; Lu, Zhibing3; Ghias, Muhammad1; Zhang, Yuan4; Patterson, Eugene1; Dasari, Tarun W.1; Zacharias, Soni1; Lazzara, Ralph1; Jackman, Warren M.1; Po, Sunny S.1
关键词: atrial fibrillation ; autonomic nervous system ; atrial tachyarrhythmia
刊名: CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY
发表日期: 2009-08-01
DOI: 10.1161/CIRCEP.108.810689
卷: 2, 期:4, 页:384-392
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: PULMONARY VEIN ; RADIOFREQUENCY ABLATION ; GANGLIONATED PLEXI ; AUTONOMIC MECHANISM ; CATHETER ABLATION ; ELECTROGRAMS CFAE ; CANINE MODEL ; CYCLE LENGTH ; FIBRILLATION ; INDUCIBILITY
英文摘要:

Background-The objective of this study was to develop an acute experimental model showing both focal and macroreentrant sustained atrial fibrillation (AF).

Methods and Results-In 31 anesthetized dogs, bilateral thoracotomies allowed the attachment of electrode catheters at the right and left superior pulmonary veins, atrial free walls, and atrial appendages. Acetylcholine, 100 mmol/L, was applied topically to either appendage. Sequential radiofrequency ablation was achieved for the ganglionated plexi (GP), found adjacent to the 4 pulmonary veins. In 12 separate studies, a propafenone bolus, 2 mg/ kg, was given before and after GP ablations at the start of acetylcholine-induced AF. Acetylcholine caused abrupt onset of AF (n = 22) or induced AF by burst pacing (n = 9) that lasted >= 10 minutes. Rapid, regular, or fractionated atrial electrograms were consistently seen (average cycle length, 37 +/- 7 ms) at the appendages versus cycle lengths of 114 +/- 23 ms at other atrial sites. After ablations of GP, AF abruptly terminated (n = 25). In 6 dogs, sustained atrial tachyarrhythmias continued. Pacing at specific atrial sites organized electrograms of one atrium or also captured the other atrium. The latter resulted in termination when pacing was stopped in 4 of these 6 experiments. Propafenone did not change the duration of focal AF before GP ablation (17 +/- 9 versus 14 +/- 8 minutes; control, P = 0.6) but terminated reentrant atrial tachyarrhythmias (12 +/- 3 versus 2 +/- 1 minutes, P = 0.0009).

Conclusions-Before GP ablation, acetylcholine (100 mmol/L) induced sustained AF characterized by rapid, focal firing. GP ablations were associated with loss of focal firing and regularization of electrograms in both atria before termination. Propafenone failed to terminate focal AF but rapidly terminated entrainable macroreentrant atrial tachyarrhythmias. (Circ Arrhythmia Electrophysiol. 2009;2:384-392.)

语种: 英语
所属项目编号: 0650077Z ; 5K23HL069972
项目资助者: American Heart Association ; National Heart, Lung, and Blood Institute ; St. Jude Medical ; Helen and Wil Webster Arrhythmia Research Fund
WOS记录号: WOS:000269162400006
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64711
Appears in Collections:北京大学第三临床医学院_期刊论文

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作者单位: 1.Univ Oklahoma, Hlth Sci Ctr, Coll Med, Heart Rhythm Inst, Oklahoma City, OK 73104 USA
2.Fuwai Hosp, Cardiovasc Inst, Arrhythmia Ctr, Beijing, Peoples R China
3.Wuhan Univ, Renmin Hosp, Dept Cardiol, Wuhan 430072, Peoples R China
4.Beijing Univ, Hosp 3, Cardiovasc Dept, Beijing 100871, Peoples R China

Recommended Citation:
Niu, Guodong,Scherlag, Benjamin J.,Lu, Zhibing,et al. An Acute Experimental Model Demonstrating 2 Different Forms of Sustained Atrial Tachyarrhythmias[J]. CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY,2009,2(4):384-392.
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