Substrate of complex fractionated atrial electrograms： evidence by pathologic analysis  

作　　者：YOU De-jun CHANG Dong ZHANG Shu-long YANG Dong-hui GAO Lian-jun YIN Xiao-meng CHU Zhen-liang XIA Yun-long WANG Yu-chun DONG Ying-xue YANG Yan-zong 

机构地区：[1]Department of Cardiology, 406th Hospital of Chinese People's Liberation Army, Dalian, Liaoning 116011, China [2]Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China [3]Department of Cardiology, Second Affiliated Hospital of Jilin University, Changchun, Jilin 130041, China [4]Department of Cardiology, Jiaxing Second Hospital, Jiaxing, Zhejiang 314000, China [5]Dalian Health Examination Center, Dalian, Liaoning 116011, China (

出　　处：《Chinese Medical Journal》2012年第24期4393-4397,共5页中华医学杂志（英文版）

基　　金：The study was supported by a grant from the National Natural Science Foundation of China （NSFC） （No. 30971272）.

摘　　要：Background Ablation of complex fractionated atrial electrograms （CFAE） is an important adjunctive therapy in atrial fibrillation （AF）. The present study was to elucidate the substrate underlying CFAE. Methods Nine adult mongrel dogs were involved in the present study. AF was induced through rapid atrial pacing with vagosympathetic nerve stimulation, CFAE was recorded during AF. Ablation was performed at CFAE sites. Based on the location of the ablation scar, the atrial specimens were divided into CFAE and non-CFAE sites. Serial sections of the atrium were stained respectively with hematoxylin-eosin （HE） and the general neural marker protein gene product 9.5 （PGP9.5）. We compared the characteristics of the myocardium and the ganglionated plexus （GPs） distribution between the CFAE and non-CFAE sites. Results The myocardium of non-CFAE sites was well-organized with little intercellular substance. However, the myocardium in the CFAE site was disorganized with more interstitial tissue （（61.7±24,3）% vs, （34.1±9,2）%, P 〈0,01 ）, G Ps in the CFAE site were more abundant than in non-CFAE sites （（34.45±37.46） bundles/cm2 vs, （6.73± 8.22） bundles/cm2, P〈0.01）. Conclusion The heterogeneity Of the myocardium and GPs distribution may account for the substrate of CFAE and serve as a potential target of ablation.Background Ablation of complex fractionated atrial electrograms （CFAE） is an important adjunctive therapy in atrial fibrillation （AF）. The present study was to elucidate the substrate underlying CFAE. Methods Nine adult mongrel dogs were involved in the present study. AF was induced through rapid atrial pacing with vagosympathetic nerve stimulation, CFAE was recorded during AF. Ablation was performed at CFAE sites. Based on the location of the ablation scar, the atrial specimens were divided into CFAE and non-CFAE sites. Serial sections of the atrium were stained respectively with hematoxylin-eosin （HE） and the general neural marker protein gene product 9.5 （PGP9.5）. We compared the characteristics of the myocardium and the ganglionated plexus （GPs） distribution between the CFAE and non-CFAE sites. Results The myocardium of non-CFAE sites was well-organized with little intercellular substance. However, the myocardium in the CFAE site was disorganized with more interstitial tissue （（61.7±24,3）% vs, （34.1±9,2）%, P 〈0,01 ）, G Ps in the CFAE site were more abundant than in non-CFAE sites （（34.45±37.46） bundles/cm2 vs, （6.73± 8.22） bundles/cm2, P〈0.01）. Conclusion The heterogeneity Of the myocardium and GPs distribution may account for the substrate of CFAE and serve as a potential target of ablation.

关 键 词：complex fractionated atrial electrograms atrial fibrillation pathologic examination ganglionated plexus 

分 类 号：R541.75[医药卫生—心血管疾病]