Pulmonary vein region ablation in experimental vagal atrial fibrillation: role of pulmonary veins versus autonomic ganglia.
Kristina Lemola,Denis Chartier,Yung-Hsin Yeh,Marc Dubuc,Raymond Cartier,Andrew Armour,Michael Ting,Masao Sakabe,Akiko Shiroshita-Takeshita,Philippe Comtois,Stanley Nattel +10 more
TLDR
Intact PVs are not needed for maintenance of experimental cholinergic AF and ablation of the autonomic ganglia at the base of the PVs suppresses vagal responses and may contribute to the effectiveness of PV-directed ablation procedures in vagal AF.Abstract:
Background— Pulmonary vein (PV) –encircling radiofrequency ablation frequently is effective in vagal atrial fibrillation (AF), and there is evidence that PVs may be particularly prone to cholinergically induced arrhythmia mechanisms. However, PV ablation procedures also can affect intracardiac autonomic ganglia. The present study examined the relative role of PVs versus peri-PV autonomic ganglia in an experimental vagal AF model. Methods and Results— Cholinergic AF was studied under carbachol infusion in coronary perfused canine left atrial PV preparations in vitro and with cervical vagal stimulation in vivo. Carbachol caused dose-dependent AF promotion in vitro, which was not affected by excision of all PVs. Sustained AF could be induced easily in all dogs during vagal nerve stimulation in vivo both before and after isolation of all PVs with encircling lesions created by a bipolar radiofrequency ablation clamp device. PV elimination had no effect on atrial effective refractory period or its responses to ...read more
Citations
More filters
Journal ArticleDOI
2017 HRS / EHRA / ECAS / APHRS / SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation
Hugh Calkins,Gerhard Hindricks,Riccardo Cappato,Young Hoon Kim,Eduardo B. Saad,Luis Aguinaga,Joseph G. Akar,Vinay Badhwar,Josep Brugada,John Camm,Peng Sheng Chen,Shih Ann Chen,Mina K. Chung,Jens Cosedis Nielsen,Anne B. Curtis,D. Wyn Davies,John D. Day,Andre d'Avila,N. M. S. de Groot,Luigi Di Biase,Mattias Duytschaever,James R. Edgerton,Kenneth A. Ellenbogen,Patrick T. Ellinor,Sabine Ernst,Guilherme Fenelon,Edward P. Gerstenfeld,David E. Haines,Michel Haïssaguerre,Robert H. Helm,Elaine M. Hylek,Warren M. Jackman,José Jalife,José Jalife,Jonathan M. Kalman,Josef Kautzner,Hans Kottkamp,Karl Heinz Kuck,Koichiro Kumagai,Richard Lee,Thorsten Lewalter,Bruce D. Lindsay,Laurent Macle,Moussa Mansour,Francis E. Marchlinski,Gregory F. Michaud,Hiroshi Nakagawa,Andrea Natale,Stanley Nattel,Ken Okumura,Douglas L. Packer,Evgeny Pokushalov,Matthew R. Reynolds,Prashanthan Sanders,Mauricio Scanavacca,Richard J. Schilling,Claudio Tondo,Hsuan Ming Tsao,Atul Verma,David J. Wilber,Teiichi Yamane +60 more
TL;DR: This 2017 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a writing group, convened by these five international societies.
Journal ArticleDOI
Pathophysiological Mechanisms of Atrial Fibrillation: A Translational Appraisal
TL;DR: A translational overview on the biological basis of atrial remodeling and the proarrhythmic mechanisms involved in the fibrillation process is given.
Journal ArticleDOI
Atrial Fibrillation Pathophysiology Implications for Management
TL;DR: The basic pathophysiology of AF is reviewed over a broad range of levels, touching on the tissue mechanisms that maintain the arrhythmia, the relationship between clinical presentation and basic mechanisms, ion channel and transporter abnormalities that lead to ectopic impulse formation, and the implications for improved rhythm control pharmacotherapy.
Journal ArticleDOI
Role of the Autonomic Nervous System in Modulating Cardiac Arrhythmias
Mark J. Shen,Douglas P. Zipes +1 more
TL;DR: Neural modulation as a treatment for arrhythmias has been well established in certain diseases, such as long QT syndrome, however, in most other arrhythmia diseases, it is still an emerging modality and under investigation.
Journal ArticleDOI
EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: Definition, characterization, and clinical implication
Andreas Goette,Jonathan M. Kalman,Luis Aguinaga,Joseph G. Akar,José Angel Cabrera,Shih Ann Chen,Sumeet S. Chugh,Domenico Corradi,Andre d'Avila,Dobromir Dobrev,Guilherme Fenelon,Mario D. Gonzalez,Stéphane N. Hatem,Robert H. Helm,Gerhard Hindricks,Siew Yen Ho,Brian Hoit,José Jalife,Young Hoon Kim,Gregory Y.H. Lip,Chang Sheng Ma,Gregory M. Marcus,Katherine T. Murray,Akihiko Nogami,Prashanthan Sanders,William Uribe,David R. Van Wagoner,Stanley Nattel,Stanley Nattel +28 more
TL;DR: The working group proposes the following working definition of atrial cardiomyopathy: ‘Any complex of structural, architectural, contractile or electrophysiological changes affecting the atria with the potential to produce clinically-relevant manifestations’ (Table 1).
References
More filters
Journal ArticleDOI
Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins
Michel Haïssaguerre,Pierre Jaïs,D. C. Shah,Atsushi Takahashi,Mélèze Hocini,G Quiniou,S. Garrigue,A Le Mouroux,P Le Métayer,Jacques Clementy +9 more
TL;DR: The pulmonary veins are an important source of ectopic beats, initiating frequent paroxysms of atrial fibrillation and these foci respond to treatment with radio-frequency ablation.
Journal ArticleDOI
Pulmonary Vein Denervation Enhances Long-Term Benefit After Circumferential Ablation for Paroxysmal Atrial Fibrillation
Carlo Pappone,Vincenzo Santinelli,Francesco Manguso,Gabriele Vicedomini,Filippo Gugliotta,Giuseppe Augello,Patrizio Mazzone,Valter Tortoriello,Giovanni Landoni,Alberto Zangrillo,Christopher Lang,Takeshi Tomita,Cézar Mesas,Elio Mastella,Ottavio Alfieri +14 more
TL;DR: It is suggested that adjunctive CVD during CPVA significantly reduces recurrence of AF at 12 months, particularly in patients with reflexes and CVD, who were less likely to have recurrent AF than those without reflexes.
Journal ArticleDOI
Catheter Ablation for Paroxysmal Atrial Fibrillation Segmental Pulmonary Vein Ostial Ablation Versus Left Atrial Ablation
Hakan Oral,Christoph Scharf,Aman Chugh,Burr Hall,Peter Cheung,Eric Good,Srikar Veerareddy,Frank Pelosi,Fred Morady +8 more
TL;DR: In patients undergoing catheter ablation for PAF, LACA to encircle the PVs is more effective than SOCA, and the only complication was left atrial flutter in a patient who underwent LACA.
Journal ArticleDOI
Stable Microreentrant Sources as a Mechanism of Atrial Fibrillation in the Isolated Sheep Heart
TL;DR: Stable microreentrant sources are the most likely underlying mechanism of AF in this model and frequency sampling allows rapid identification of discrete sites of high-frequency periodic activity during AF.
Journal ArticleDOI
Gross and microscopic anatomy of the human intrinsic cardiac nervous system
TL;DR: The extent and locations of intrinsic cardiac ganglia on the human heart were investigated to facilitate studying their function.