Arrhythmogenic Substrate of the Pulmonary Veins Assessed by High-Resolution Optical Mapping

DOI Web Site 被引用文献22件
  • Rishi Arora
    From the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.
  • Sander Verheule
    From the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.
  • Luis Scott
    From the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.
  • Antonio Navarrete
    From the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.
  • Vikram Katari
    From the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.
  • Emily Wilson
    From the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.
  • Dev Vaz
    From the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.
  • Jeffrey E. Olgin
    From the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis.

抄録

<jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> It has recently been recognized that atrial fibrillation can originate from focal sources in the pulmonary veins (PVs). However, the mechanisms of focal atrial fibrillation have not been well characterized. We assessed the electrophysiological characteristics of the PVs using high-resolution optical mapping. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> Coronary-perfused, isolated whole-atrial preparations from 33 normal dogs were studied. Programmed electrical stimulation was performed, and a 4-cm <jats:sup>2</jats:sup> area of the PV underwent optical mapping of transmembrane voltage to obtain 256 simultaneous action potentials. Marked conduction slowing was seen at the proximal PV, compared with the rest of the vein, on both the epicardial (31.3±4.47 versus 90.2±20.7 cm/s, <jats:italic>P</jats:italic> =0.001) and endocardial (45.8±6.90 versus 67.6±10.4 cm/s, <jats:italic>P</jats:italic> =0.012) aspects. Pronounced repolarization heterogeneity was also noted, with action potential duration at 80% repolarization being longest at the PV endocardium. Nonsustained reentrant beats were induced with single extrastimuli, and the complete reentrant loop was visualized (cycle length, 155±30.3 ms); reentrant activity could be sustained with isoproterenol. Sustained focal discharge (cycle length, 330 to 1100 ms) was seen from the endocardial surface in the presence of isoproterenol; each focus was localized near the venous ostium. </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> The normal PV seems to have the necessary substrate to support reentry as well as focal activity. Although reentry occurred more distally in the vein, focal activity seemed to occur more proximally. </jats:p>

収録刊行物

  • Circulation

    Circulation 107 (13), 1816-1821, 2003-04-08

    Ovid Technologies (Wolters Kluwer Health)

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