Pulmonary vein region ablation in experimental vagal atrial fibrillation: role of pulmonary veins versus autonomic ganglia.

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 cholinergic stimulation. Autonomic ganglia were identified by bradycardic and/or tachycardic responses to high-frequency subthreshold local stimulation. Ablation of the autonomic ganglia overlying all PV ostia suppressed the effective refractory period-abbreviating and AF-promoting effects of cervical vagal stimulation, whereas ablation of only left- or right-sided PV ostial ganglia failed to suppress AF. Dominant-frequency analysis suggested that the success of ablation in suppressing vagal AF depended on the elimination of high-frequency driver regions. CONCLUSIONS:Intact PVs are not needed for maintenance of experimental cholinergic AF. 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.

journal_name

Circulation

journal_title

Circulation

authors

Lemola K,Chartier D,Yeh YH,Dubuc M,Cartier R,Armour A,Ting M,Sakabe M,Shiroshita-Takeshita A,Comtois P,Nattel S

doi

10.1161/CIRCULATIONAHA.107.737023

subject

Has Abstract

pub_date

2008-01-29 00:00:00

pages

470-7

issue

4

eissn

0009-7322

issn

1524-4539

pii

CIRCULATIONAHA.107.737023

journal_volume

117

pub_type

杂志文章
  • RR variability in healthy, middle-aged persons compared with patients with chronic coronary heart disease or recent acute myocardial infarction.

    abstract:BACKGROUND:The purpose of this investigation was to establish normal values of RR variability for middle-aged persons and compare them with values found in patients early and late after myocardial infarction. We hypothesized that presence or absence of coronary heart disease, age, and sex (in this order of importance) ...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1161/01.cir.91.7.1936

    authors: Bigger JT Jr,Fleiss JL,Steinman RC,Rolnitzky LM,Schneider WJ,Stein PK

    更新日期:1995-04-01 00:00:00

  • Cardiovascular response to dynamic exercise in patients with chronic symptomatic mild-to-moderate and severe aortic regurgitation.

    abstract::Fifteen patients with symptomatic mild-to-moderate and severe chronic aortic regurgitation (AR) performed supine bicycle exercise while measurements of rest and exercise hemodynamics and left ventricular function were obtained. A continuous Doppler method was used to determine the change in distribution of total left ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.73.1.62

    authors: Kawanishi DT,McKay CR,Chandraratna PA,Nanna M,Reid CL,Elkayam U,Siegel M,Rahimtoola SH

    更新日期:1986-01-01 00:00:00

  • Beta fibrinogen gene polymorphisms are associated with plasma fibrinogen and coronary artery disease in patients with myocardial infarction. The ECTIM Study. Etude Cas-Temoins sur l'Infarctus du Myocarde.

    abstract:BACKGROUND:Polymorphisms of the beta fibrinogen gene have been shown to affect plasma fibrinogen levels and the risk of peripheral arterial disease. We now present the results of a detailed analysis of the beta fibrinogen gene in relation to plasma fibrinogen and to the severity of coronary artery disease (CAD) in pati...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/01.cir.93.3.440

    authors: Behague I,Poirier O,Nicaud V,Evans A,Arveiler D,Luc G,Cambou JP,Scarabin PY,Bara L,Green F,Cambien F

    更新日期:1996-02-01 00:00:00

  • Reentry as a cause of ventricular tachycardia in patients with chronic ischemic heart disease: electrophysiologic and anatomic correlation.

    abstract::In this report we describe electrophysiologic and histologic findings in hearts and endocardially resected preparations from patients with sustained ventricular tachycardias in the chronic phase of myocardial infarction. We recorded simultaneously from 64 endocardial sites during tachycardia in 72 patients that were o...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.77.3.589

    authors: de Bakker JM,van Capelle FJ,Janse MJ,Wilde AA,Coronel R,Becker AE,Dingemans KP,van Hemel NM,Hauer RN

    更新日期:1988-03-01 00:00:00

  • Acute cardiovascular effects of fetal surgery in the human.

    abstract:BACKGROUND:Prenatal surgery for congenital anomalies can prevent fetal demise or alter the course of organ development, resulting in a more favorable condition at birth. The indications for fetal surgery continue to expand, yet little is known about the acute sequelae of fetal surgery on the human cardiovascular system...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:10.1161/01.CIR.0000142294.95388.C4

    authors: Rychik J,Tian Z,Cohen MS,Ewing SG,Cohen D,Howell LJ,Wilson RD,Johnson MP,Hedrick HL,Flake AW,Crombleholme TM,Adzick NS

    更新日期:2004-09-21 00:00:00

  • Two-dimensional echocardiographic findings in atrial septal defect.

    abstract::Two-dimensional echocardiographic findings in a group of 24 patients with atrial septal defects were correlated with findings obtained by cardiac catheterization and M-mode echocardiography. The prevalence of mitral prolapse was 95% by two-dimensional echocardiography and 59% by angiography in patients with secundum a...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.56.3.447

    authors: Lieppe W,Scallion R,Behar VS,Kisslo JA

    更新日期:1977-09-01 00:00:00

  • Assessment of systemic right ventricular function in patients with transposition of the great arteries using the myocardial performance index: comparison with cardiac magnetic resonance imaging.

    abstract:BACKGROUND:Assessment of systemic right ventricular (RV) function is a key point in the follow-up of patients with transposition of the great arteries (TGA). Current echocardiographic assessment of RV function is at best an estimate, and cardiac magnetic resonance (CMR) is considered the gold standard. However, this te...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000147284.54140.73

    authors: Salehian O,Schwerzmann M,Merchant N,Webb GD,Siu SC,Therrien J

    更新日期:2004-11-16 00:00:00

  • Effect of surgical reduction of left ventricular outflow obstruction on hemodynamics, coronary flow, and myocardial metabolism in hypertrophic cardiomyopathy.

    abstract::To assess the impact of operative reduction of left ventricular outflow obstruction in hypertrophic cardiomyopathy, measurements of great cardiac vein flow, oxygen and lactate content, left ventricular pressures, and cardiac index were measured at rest and during pacing stress in 20 consecutive patients (13, myotomy-m...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.79.4.766

    authors: Cannon RO 3rd,McIntosh CL,Schenke WH,Maron BJ,Bonow RO,Epstein SE

    更新日期:1989-04-01 00:00:00

  • Endocardial catheter mapping: wire skeleton technique for representation of computed arrhythmogenic sites compared with intraoperative mapping.

    abstract::Guiding surgical therapy of ventricular tachycardia by preoperative endocardial catheter mapping necessitates improvement of the accuracy of localization of the arrhythmogenic site. We therefore used a new mathematical cineradiographic method during catheter mapping to compute the position of left ventricular arrhythm...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.74.6.1346

    authors: Hauer RN,de Zwart MT,de Bakker JM,Hitchcock JF,Penn OC,Nijsen-Karelse M,Robles de Medina EO

    更新日期:1986-12-01 00:00:00

  • Impaired maximal rate of left ventricular relaxation in patients with coronary artery disease and left ventricular dysfunction.

    abstract::It has been suggested that the rate of left ventricular (LV) relaxation is related to the inotropic state, end-systolic fiber length and peak LV pressure, but little information is available regarding the rate of LV relaxation in patients with coronary artery disease (CAD) and LV dysfunction. To assess the rate of LV ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.59.5.984

    authors: Papapietro SE,Coghlan HC,Zissermann D,Russell RO Jr,Rackley CE,Rogers WJ

    更新日期:1979-05-01 00:00:00

  • Linkage analysis and long QT syndrome. Using genetics to study cardiovascular disease.

    abstract:BACKGROUND:Recombinant DNA technologies have facilitated the development of a set of polymorphic DNA markers covering the human genome. General linkage analysis in families predisposed to inherited disease is now feasible. Linkage analysis can help identify a disease gene even when relatively little is known about the ...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:10.1161/01.cir.85.6.1973

    authors: Keating M

    更新日期:1992-06-01 00:00:00

  • Atrioventricular nodal reentrant tachycardia: studies on upper and lower 'common pathways'.

    abstract::Electrophysiologic studies were performed in 28 patients with documented atrioventricular (AV) nodal reentrant supraventricular tachycardia (SVT) to investigate the presence of AV nodal tissue situated between the tachycardia circuit and both the atrium (upper common pathway, UCP) and the His bundle (lower common path...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.75.5.930

    authors: Miller JM,Rosenthal ME,Vassallo JA,Josephson ME

    更新日期:1987-05-01 00:00:00

  • Loss of Mdm4 results in p53-dependent dilated cardiomyopathy.

    abstract:BACKGROUND:Although several loci for familial dilated cardiomyopathy (DCM) have been mapped, the origin of a large percentage of DCM remains unclear. Mdm2, a p53-negative regulator, protects cardiomyocytes from ischemic and reperfusion-induced cell death. Mdm4, a homolog of Mdm2, inhibits p53 activity in numerous cell ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.107.689901

    authors: Xiong S,Van Pelt CS,Elizondo-Fraire AC,Fernandez-Garcia B,Lozano G

    更新日期:2007-06-12 00:00:00

  • Hydroxymethylglutaryl coenzyme A reductase inhibition reduces Chlamydia pneumoniae-induced cell interaction and activation.

    abstract:BACKGROUND:Chlamydia pneumoniae stimulates chronic inflammation in vascular cells. Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) may have an ameliorating effect. We investigated possible mechanisms. METHODS AND RESULTS:We infected human macrophages that in coculture spread infection to vascular smoot...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000083367.93022.78

    authors: Dechend R,Gieffers J,Dietz R,Joerres A,Rupp J,Luft FC,Maass M

    更新日期:2003-07-22 00:00:00

  • Both hepatic and extrahepatic ABCA1 have discrete and essential functions in the maintenance of plasma high-density lipoprotein cholesterol levels in vivo.

    abstract:BACKGROUND:Extrahepatic tissues have long been considered critical contributors of cholesterol to nascent HDL particles in the reverse cholesterol transport pathway, in which ABCA1 plays the crucial role. Recent studies, however, including both overexpression and deletion of ABCA1 selectively in the liver, have highlig...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.106.621433

    authors: Singaraja RR,Van Eck M,Bissada N,Zimetti F,Collins HL,Hildebrand RB,Hayden A,Brunham LR,Kang MH,Fruchart JC,Van Berkel TJ,Parks JS,Staels B,Rothblat GH,Fiévet C,Hayden MR

    更新日期:2006-09-19 00:00:00

  • Low-Attenuation Noncalcified Plaque on Coronary Computed Tomography Angiography Predicts Myocardial Infarction: Results From the Multicenter SCOT-HEART Trial (Scottish Computed Tomography of the HEART).

    abstract:BACKGROUND:The future risk of myocardial infarction is commonly assessed using cardiovascular risk scores, coronary artery calcium score, or coronary artery stenosis severity. We assessed whether noncalcified low-attenuation plaque burden on coronary CT angiography (CCTA) might be a better predictor of the future risk ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.119.044720

    authors: Williams MC,Kwiecinski J,Doris M,McElhinney P,D'Souza MS,Cadet S,Adamson PD,Moss AJ,Alam S,Hunter A,Shah ASV,Mills NL,Pawade T,Wang C,Weir McCall J,Bonnici-Mallia M,Murrills C,Roditi G,van Beek EJR,Shaw LJ,Nicol E

    更新日期:2020-05-05 00:00:00

  • Late survival and symptoms after repair of tetralogy of Fallot.

    abstract::The long-term results of 414 patients who underwent repair of tetralogy of Fallot between 1967 and 1977 were studied and correlated with the results of others. There were nine late deaths (8-year actuarial survival 95.8%). Six of the deaths wee directly related to the malformation or its treatment. Eight patients (2.4...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.65.2.403

    authors: Katz NM,Blackstone EH,Kirklin JW,Pacifico AD,Bargeron LM Jr

    更新日期:1982-02-01 00:00:00

  • Ability of recombinant factor VIIa to reverse the anticoagulant effect of the pentasaccharide fondaparinux in healthy volunteers.

    abstract:BACKGROUND:The novel anticoagulant fondaparinux proved to be effective and safe in the postoperative prevention of venous thrombosis. Current phase III trials with this synthetic selective factor Xa inhibitor focus on its use in the treatment of patients with venous and arterial thrombosis. As with any anticoagulant th...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.0000038501.87442.02

    authors: Bijsterveld NR,Moons AH,Boekholdt SM,van Aken BE,Fennema H,Peters RJ,Meijers JC,Büller HR,Levi M

    更新日期:2002-11-12 00:00:00

  • Complete isolation of left atrium surrounding the pulmonary veins: new insights from the double-Lasso technique in paroxysmal atrial fibrillation.

    abstract:BACKGROUND:Paroxysmal atrial fibrillation (PAF) can be eliminated with continuous circular lesions (CCLs) around the pulmonary veins (PVs), but it is unclear whether all PVs are completely isolated. METHODS AND RESULTS:Forty-one patients with symptomatic PAF underwent 3D mapping, and all PV ostia were marked on the 3D...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000144459.37455.EE

    authors: Ouyang F,Bänsch D,Ernst S,Schaumann A,Hachiya H,Chen M,Chun J,Falk P,Khanedani A,Antz M,Kuck KH

    更新日期:2004-10-12 00:00:00

  • Impact of nonoperative therapy on the clinical management of peripheral arterial disease.

    abstract::Nonoperative therapy includes conservative noninterventional modalities and the endovascular interventional modalities of percutaneous transluminal angioplasty and a variety of laser systems and atherectomy devices. The role and impact of all nonoperative treatments are considered in the perspectives of the natural hi...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:

    authors: Veith FJ,Gupta SK,Wengerter KR,Rivers SP,Bakal CW

    更新日期:1991-02-01 00:00:00

  • Uric acid and survival in chronic heart failure: validation and application in metabolic, functional, and hemodynamic staging.

    abstract:BACKGROUND:Serum uric acid (UA) could be a valid prognostic marker and useful for metabolic, hemodynamic, and functional (MFH) staging in chronic heart failure (CHF). METHODS AND RESULTS:For the derivation study, 112 patients with CHF (age 59+/-12 years, peak oxygen consumption [Vo2] 17+/-7 mL/kg per minute) were recr...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000065637.10517.A0

    authors: Anker SD,Doehner W,Rauchhaus M,Sharma R,Francis D,Knosalla C,Davos CH,Cicoira M,Shamim W,Kemp M,Segal R,Osterziel KJ,Leyva F,Hetzer R,Ponikowski P,Coats AJ

    更新日期:2003-04-22 00:00:00

  • Histologic evidence for small-vessel coronary artery disease in patients with angina pectoris and patent large coronary arteries.

    abstract::We studied six patients who suffered from angina pectoris but had angiographically patent major coronary arteries. Two of the patients suffered also from congestive heart failure. Three patients had supraventricular tachyarrhythmias. Three patients had conduction disturbances. During coronary angiography the patients ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.74.5.964

    authors: Mosseri M,Yarom R,Gotsman MS,Hasin Y

    更新日期:1986-11-01 00:00:00

  • Femoropopliteal angioplasty. Factors influencing long-term success.

    abstract::Prospective data was recorded on 217 percutaneous transluminal angioplasty (PTA) procedures performed in the superficial femoral and popliteal arteries over an 8-year period. After the initial procedure, patients were followed with serial noninvasive studies and, in 71 patients, repeat angiography. The mean follow-up ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Capek P,McLean GK,Berkowitz HD

    更新日期:1991-02-01 00:00:00

  • Prediction of the localization of high-risk coronary atherosclerotic plaques on the basis of low endothelial shear stress: an intravascular ultrasound and histopathology natural history study.

    abstract:BACKGROUND:Low endothelial shear stress (ESS) promotes the development of atherosclerosis; however, its role in the progression of atherosclerotic plaques and evolution to inflamed high-risk plaques has not been studied. Our hypothesis was that the lowest values of ESS are responsible for the development of high-risk c...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.107.695254

    authors: Chatzizisis YS,Jonas M,Coskun AU,Beigel R,Stone BV,Maynard C,Gerrity RG,Daley W,Rogers C,Edelman ER,Feldman CL,Stone PH

    更新日期:2008-02-26 00:00:00

  • Evidence for increased collagenolysis by interstitial collagenases-1 and -3 in vulnerable human atheromatous plaques.

    abstract:BACKGROUND:Several recent studies attempted to classify plaques as those prone to cause clinical manifestations (vulnerable, atheromatous plaques) or those less frequently associated with acute thrombotic complication (stable, fibrous plaques). Defining the cellular and molecular mechanisms that underlie these morpholo...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.99.19.2503

    authors: Sukhova GK,Schönbeck U,Rabkin E,Schoen FJ,Poole AR,Billinghurst RC,Libby P

    更新日期:1999-05-18 00:00:00

  • Cytomegalovirus infection with interleukin-6 response predicts cardiac mortality in patients with coronary artery disease.

    abstract:BACKGROUND:Prospective data relating previous exposure to cytomegalovirus (CMV) to the risk of cardiac mortality are controversial. We investigated the effect of previous exposure to CMV infection on the risk of future cardiac disease-related death in relation to an underlying inflammatory response. METHODS AND RESULT...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.103.24.2915

    authors: Blankenberg S,Rupprecht HJ,Bickel C,Espinola-Klein C,Rippin G,Hafner G,Ossendorf M,Steinhagen K,Meyer J

    更新日期:2001-06-19 00:00:00

  • Spontaneous near closure of coronary artery fistula.

    abstract::An asymptomatic 14-year-old male was found at cardiac catheterization to have a coronary artery fistula involving a vessel originating from the left main coronary artery and terminating in the right heart. Chest X-ray and electrocardiogram were within normal limits and shunt flow was too small to be detected by oximet...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.57.1.197

    authors: Shubrooks SJ Jr,Naggar CZ

    更新日期:1978-01-01 00:00:00

  • Repeat coronary revascularization after coronary artery bypass surgery in older adults: the Society of Thoracic Surgeons' national experience, 1991-2007.

    abstract:BACKGROUND:A major advantage of coronary artery bypass graft surgery (CABG) relative to percutaneous coronary intervention is its durability, yet there is a paucity of information on rates and predictors of repeat coronary revascularization after CABG in the modern era. METHODS AND RESULTS:We included patients ≥65 yea...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.113.001882

    authors: Fosbøl EL,Zhao Y,Shahian DM,Grover FL,Edwards FH,Peterson ED

    更新日期:2013-04-23 00:00:00

  • Beat-to-beat analysis of left ventricular pressure-volume relation and stroke volume by conductance catheter and aortic Modelflow in cardiomyoplasty patients.

    abstract:BACKGROUND:Since the clinical introduction of dynamic cardiomyoplasty, a discrepancy has been observed between unchanged measurements of cardiac function and improved clinical outcome. METHODS AND RESULTS:We performed a beat-to-beat analysis of cardiac performance at rest in nine cardiomyoplasty patients 6 to 24 month...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.91.7.2010

    authors: Schreuder JJ,van der Veen FH,van der Velde ET,Delahaye F,Alfieri O,Jegaden O,Lorusso R,Jansen JR,van Ommen V,Finet G

    更新日期:1995-04-01 00:00:00

  • Twenty-four-hour ambulatory blood pressure in shift workers.

    abstract::Blood pressure and heart rate of 15 male shift workers were measured every 15 minutes for 24 hours during three work shifts: morning, 4:00 AM to noon; afternoon, noon to 8:00 PM; and night, 8:00 PM to 4:00 AM. For each shift, 24-hour systolic and diastolic blood pressure showed a large "trough" (the low pressure span)...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.80.2.341

    authors: Chau NP,Mallion JM,de Gaudemaris R,Ruche E,Siche JP,Pelen O,Mathern G

    更新日期:1989-08-01 00:00:00