Relationship between intrinsic cardiac autonomic Ganglionated Plexi and the atrial fibrillation nest

Hung Yu Chang, Li Wei Lo, Yenn Jiang Lin, Shih Huang Lee, Chuen Wang Chiou, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: Spectral analysis of the left atrium can identify high dominant frequency (DF) sites, which might play a role in the perpetuation of atrial fibrillation (AF). Furthermore, the role of the cardiac autonomic nervous system (CANS) in the genesis of AF has been demonstrated. The relationship between CANS and the high-DF sites (AF nest) was the aim of the investigation. Methods and Results: In 12 dogs, high frequency stimulation was applied to locate 4 major left atrial (LA) ganglion-ated plexi (GPs). An Ensite Array and a mapping catheter were delivered into the left atrium for electroanatomical mapping. During sinus rhythm, spectral analysis was performed on the bipolar electrograms in the left atrium before and after epicardial GP ablation. The majority of AF nests were close to the GPs (52±18% of total AF nests). After GP ablation, the mean LA DF values decreased from 54±7 Hz to 49±4 Hz (P=0.023), and DF values of the AF nest decreased from 93±2 Hz to 87±4 Hz (P=0.001). Most of the previous AF nest sites close to the GPs disappeared (85±23%). The surface area of the AF nest decreased from 9±5 cm2 to 3±2 cm2 (P=0.001). Conclusions: Catheter ablation of the GP decreased the DF values, AF nest areas and diminished the number of AF nests; particularly those close to the GPs, indicating that the CANS might play an important role in the mechanism of the AF nest.

Original languageEnglish
Pages (from-to)922-928
Number of pages7
JournalCirculation Journal
Volume78
Issue number4
DOIs
StatePublished - 2014

Keywords

  • Ablation
  • Atrial fibrillation
  • Autonomic
  • Ganglionated plexus

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