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Text
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<a href="http://doi.org/10.1161/CIRCEP.114.001578" target="_blank" rel="noreferrer noopener">http://doi.org/10.1161/CIRCEP.114.001578</a>
Pages
1181–1188
Issue
6
Volume
7
Dublin Core
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Title
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Isolation of canine coronary sinus musculature from the atria by radiofrequency catheter ablation prevents induction of atrial fibrillation.
Publisher
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Circulation. Arrhythmia and electrophysiology
Date
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2014
2014-12
Subject
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*Catheter Ablation; Acetylcholine; Action Potentials; Animal; Animal Studies; Animals; Artificial; atrial fibrillation; Atrial Fibrillation – Etiology; Atrial Fibrillation – Physiopathology; Atrial Fibrillation – Prevention and Control; Atrial Fibrillation/etiology/physiopathology/*prevention & control; Biological; Body Surface Potential Mapping; Cardiac Pacing; catheter ablation; Catheter Ablation; coronary sinus; Coronary Sinus/physiopathology/*surgery; Coronary Vessels – Physiopathology; Coronary Vessels – Surgery; Disease Models; Dogs; Heart Atria/physiopathology/surgery; Heart Atrium – Physiopathology; Heart Atrium – Surgery; Male; Models; optical Vm mapping; Time Factors
Creator
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Morita Hiroshi; Zipes Douglas P; Morita Shiho T; Wu Jiashin
Description
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BACKGROUND: The junction between the coronary sinus (CS) musculature and both atria contributes to initiation of atrial tachyarrhythmias. The current study investigated the effects of CS isolation from the atria by radiofrequency catheter ablation on the induction and maintenance of atrial fibrillation (AF). METHODS AND RESULTS: Using an optical mapping system, we mapped action potentials at 256 surface sites in 17 isolated and arterially perfused canine atrial tissues containing the entire musculature of the CS, right atrial septum, posterior left atrium, left inferior pulmonary vein, and vein of Marshal. Rapid pacing from each site before and after addition of acetylcholine (0.5 mumol/L) was applied to induce AF. Epicardial radiofrequency catheter ablation at CS-atrial junctions isolated the CS from the atria. Rapid pacing induced sustained AF in all tissues after acetylcholine. Microreentry within the CS drove AF in 88% of preparations. Reentries associated with the vein of Marshall (29%), CS-atrial junctions (53%), right atrium (65%), and pulmonary vein (76%) (frequently with 2-4 simultaneous circuits) were additional drivers of AF. Radiofrequency catheter ablation eliminated AF in 13 tissues before acetylcholine (P\textless0.01) and in 5 tissues after acetylcholine. Radiofrequency catheter ablation also abbreviated the duration of AF in 12 tissues (P\textless0.01). CONCLUSIONS: CS and its musculature developed unstable reentry and AF, which were prevented by isolation of CS musculature from atrial tissue. The results suggest that CS can be a substrate of recurrent AF in patients after pulmonary vein isolation and that CS isolation might help prevent recurrent AF.
Identifier
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<a href="http://doi.org/10.1161/CIRCEP.114.001578" target="_blank" rel="noreferrer noopener">10.1161/CIRCEP.114.001578</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Catheter Ablation
2014
Acetylcholine
Action Potentials
Animal
Animal Studies
Animals
Artificial
Atrial fibrillation
Atrial Fibrillation – Etiology
Atrial Fibrillation – Physiopathology
Atrial Fibrillation – Prevention and Control
Atrial Fibrillation/etiology/physiopathology/*prevention & control
Biological
Body Surface Potential Mapping
Cardiac Pacing
Catheter Ablation
Circulation. Arrhythmia and electrophysiology
coronary sinus
Coronary Sinus/physiopathology/*surgery
Coronary Vessels – Physiopathology
Coronary Vessels – Surgery
Disease Models
Dogs
Heart Atria/physiopathology/surgery
Heart Atrium – Physiopathology
Heart Atrium – Surgery
Male
Models
Morita Hiroshi
Morita Shiho T
optical Vm mapping
Time Factors
Wu Jiashin
Zipes Douglas P