Effect of ablation of complex fractionated atrial electrogram on vagal modulation in dogs  

作　　者：ZHANG Shu-long DONG Ying-xue JIANG Peng GAO Lian-jun CHA Yong-mei Douglas L. Packer XIA Yun-long YIN Xiao-meng CHANG Dong YANG Yan-zong 

机构地区：[1]Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China [2]Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA

出　　处：《Chinese Medical Journal》2010年第22期3288-3292,共5页中华医学杂志（英文版）

基　　金：This study was supported by the grants from National Natural Science Foundation of China （No. 30770866, 30971272）.

摘　　要：Background Clinical observations have shown that the complex fractionated atrial electrogram （CFAE） associates with ganglionated plexus activity in the cardiac autonomic nervous system. This study aimed to investigate the impact of CFAE ablation on vagal modulation to atria and vulnerability to develop atrial fibrillation （AF）. Methods Ten adult mongrel dogs were involved. Cervical sympathovagal trunks were decentralized and sympathetic effects were blocked. CFAE was color tagged on the atrial 3-dimensional image and ablated during AF induced by S1S2 programmed stimulation plus sympathovagal trunk stimulation. Atrial effective refractory period （ERP） and vulnerability window （VW） of AF were measured on baseline and at vagal stimulation at 4 atrium sites. Serial tissue sections from ablative and control specimens received hematoxylin and eosin staining for microscopic examination. Results Most CFAE areas were localized at the right superior pulmonary quadrant, distal coronary sinus （CS~） quadrant, and proximal coronary sinus （CSp） quadrant （21.74%, separately）. Sinus rhythm cycle length （SCL） shortening did not decrease significantly after ablation at the sites, including right atrial appendage, left atrial appendage, CSd, and CSp （P 〉0.05）. ERP shortening during vagal stimulation significantly decreased after ablation （P 〈0.01）; the VW to vagal stimulation significantly decreased after ablation （P 〈0.05）. The architecture of individual ganglia altered after ablation. Conclusions CFAE has an autonomic basis in dogs. The decreased SCL and ERP shortening to vagal stimulation after CFAE ablation demonstrate that CFAE ablation attenuates vagal modulation to the atria, thereby suppressing AF mediated by enhanced vagal activity. CFAE ablation could suppress AF mediated by enhanced vagal activity.Background Clinical observations have shown that the complex fractionated atrial electrogram （CFAE） associates with ganglionated plexus activity in the cardiac autonomic nervous system. This study aimed to investigate the impact of CFAE ablation on vagal modulation to atria and vulnerability to develop atrial fibrillation （AF）. Methods Ten adult mongrel dogs were involved. Cervical sympathovagal trunks were decentralized and sympathetic effects were blocked. CFAE was color tagged on the atrial 3-dimensional image and ablated during AF induced by S1S2 programmed stimulation plus sympathovagal trunk stimulation. Atrial effective refractory period （ERP） and vulnerability window （VW） of AF were measured on baseline and at vagal stimulation at 4 atrium sites. Serial tissue sections from ablative and control specimens received hematoxylin and eosin staining for microscopic examination. Results Most CFAE areas were localized at the right superior pulmonary quadrant, distal coronary sinus （CS~） quadrant, and proximal coronary sinus （CSp） quadrant （21.74%, separately）. Sinus rhythm cycle length （SCL） shortening did not decrease significantly after ablation at the sites, including right atrial appendage, left atrial appendage, CSd, and CSp （P 〉0.05）. ERP shortening during vagal stimulation significantly decreased after ablation （P 〈0.01）; the VW to vagal stimulation significantly decreased after ablation （P 〈0.05）. The architecture of individual ganglia altered after ablation. Conclusions CFAE has an autonomic basis in dogs. The decreased SCL and ERP shortening to vagal stimulation after CFAE ablation demonstrate that CFAE ablation attenuates vagal modulation to the atria, thereby suppressing AF mediated by enhanced vagal activity. CFAE ablation could suppress AF mediated by enhanced vagal activity.

关 键 词：atrial fibrillation autonomic nervous system catheter ablation complex fractionated atrial electrogram vagus nerve 

分 类 号：Q429.92[生物学—神经生物学] Q954.561[生物学—生理学]