Role of the Left Atrial Anatomy in the Maintenance of Three-Dimensional Scroll Waves in Acute, Stretch-Related and Cholinergic Atrial Fibrillation
スポンサーリンク
概要
- 論文の詳細を見る
The mechanisms that maintain atrial fibrillation (AF) are incompletely understood. We hypothesized that 3-D scroll waves (SWs) confined to specific left atrial (LA) anatomical structure are involved in the maintenance of stretch-related (SRAF) and cholinergic AF with stretch (ChAF). <B>Methods:</B> In 13 isolated sheep hearts, optical membrane potential images were recorded, by using two CCD cameras and a cardio-endoscope, simultaneously from the epicardial and endocardial surfaces of the posterior LA (PLA, n=8) or the LA appendage (LAA, n=5). SRAF was induced by burst pacing under increased LA pressure (12 cm H<SUB>2</SUB>O), and ChAF did so additional perfusion of 0.1 µM acetylcholine. <B>Results:</B> During SRAF, major activation pattern in LAA was either breakthrough (44%) or one-way propagation (30%), whereas that in PLA was SWs (30%), which were anchored at LA-PV junction. During ChAF, major activation pattern in LAA was SWs (53%), which were anchored at the periphery of pectinate muscles. Numerical simulations suggest that the thinnest region of LA will favor the anchoring of SWs via shortening of atrial wave length resulting from an increase of stretch-activated ion channel conductance. <B>Conclusion:</B> Transmural SWs play an important role to maintain AF induced by mechanical stretch and cholinergic stimulation. The thinnest LA region will provide a structural substrate in favor of perpetuation of these SWs.
著者
-
KODAMA Itsuo
Nagoya University
-
Yamazaki Masatoshi
University of Michigan
-
Vaquero Miguel
University of Michigan
-
Honjo Haruo
Nagoya University
-
Kamiya Kaichiro
Nagoya University
-
Kalifa Jérôme
University of Michigan
関連論文
- Non Invasive Electrophysiological Evaluation of Pilsicainide and Bepridil in Late Potential and T-Wave Variability in Patients with Proximal Atrial Fibrillation
- Non Invasive Electrophysiological Evaluation of Brugada Type ECG and Early Repolarization Potential in Healthy Young People
- Investigation of Circadian Rhythm in T-wave Variability and Other Electrocardiographic Parameters Using Ambulatory Electrocardiographic Monitoring
- Identification of High-Risk Brugada Syndrome Patients by Combined Analysis of Late Potential and T-Wave Amplitude Variability on Ambulatory Electrocardiograms
- Role of the Left Atrial Anatomy in the Maintenance of Three-Dimensional Scroll Waves in Acute, Stretch-Related and Cholinergic Atrial Fibrillation
- Guidelines for Non-Pharmacotherapy of Cardiac Arrhythmias (JCS 2011) : Digest Version
- Target International Normalized Ratio Values for Preventing Thromboembolic and Hemorrhagic Events in Japanese Patients With Non-Valvular Atrial Fibrillation:– Results of the J-RHYTHM Registry –
- Identification of High-Risk Brugada Syndrome Patients by Combined Analysis of Late Potential and T-Wave Amplitude Variability on Ambulatory Electrocardiograms
- Target International Normalized Ratio Values for Preventing Thromboembolic and Hemorrhagic Events in Japanese Patients With Non-Valvular Atrial Fibrillation : Results of the J-RHYTHM Registry