Literature DB >> 19084815

Fixed intercaval block in the setting of atrial fibrillation promotes the development of atrial flutter.

Hanh M Bui1, Celeen M Khrestian, Kyungmoo Ryu, Jayakumar Sahadevan, Albert L Waldo.   

Abstract

BACKGROUND: In the canine sterile pericarditis model, typically only atrial fibrillation (AF) is inducible on postoperative day 2.
OBJECTIVE: In this model, we tested the hypothesis that on postoperative day 2, placing a fixed line of block (LoB) between the vena cavae critically alters the atrial substrate, favoring the induction of sustained atrial flutter (AFL) instead of AF.
METHODS: In 6 sterile pericarditis dogs, sustained AF was induced by rapid atrial pacing. After terminating AF, a fixed LoB between the vena cavae was created (cryoablation), and AF reinduction was attempted. Simultaneous mapping from 400 to 420 electrodes on the right and left atrial epicardium and the interatrial atrial septum was performed during all studies.
RESULTS: Before creation of the LoB, in all 6 dogs, rapid atrial pacing induced sustained AF because of a rapid (mean cycle length [CL] 110 +/- 10 ms), regular, left atrial reentrant driver, which caused fibrillatory conduction. After creation of the LoB, in 5 dogs, rapid atrial pacing now induced sustained AFL (mean CL 167 +/- 13 ms). In the 6th dog, AFL failed to develop because the left atrial driver that was induced before the LoB was still reproducibly induced despite the LoB.
CONCLUSION: In this model of sustained AF, altering the substrate to create a fixed LoB between the vena cavae creates a substrate favoring the induction of AFL.

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Year:  2008        PMID: 19084815     DOI: 10.1016/j.hrthm.2008.08.036

Source DB:  PubMed          Journal:  Heart Rhythm        ISSN: 1547-5271            Impact factor:   6.343


  5 in total

1.  Assessment of the correlation between two defining criteria for bidirectional isthmic block in the ablation of typical atrial flutter.

Authors:  R Rosu; A Abdelaal; M Andronache; G Gusetu; L Muresan; Rp Martins; C Bondor; D Pop; A Malai; M Ilea; C Pop; D Dan; M Puschita; P Nanu; D Zdrenghea
Journal:  Indian Pacing Electrophysiol J       Date:  2011-02-07

2.  Surgical technique and the mechanism of atrial tachycardia late after open heart surgery.

Authors:  Róbert Pap; Mária Kohári; Attila Makai; Gábor Bencsik; Vassil Borislavov Traykov; Rodrigo Gallardo; Gergely Klausz; Kis Zsuzsanna; Tamás Forster; László Sághy
Journal:  J Interv Card Electrophysiol       Date:  2012-07-27       Impact factor: 1.900

3.  Paradigm shifts in electrophysiological mechanisms of atrial fibrillation.

Authors:  Ulrich Schotten; Seungyup Lee; Stef Zeemering; Albert L Waldo
Journal:  Europace       Date:  2021-04-10       Impact factor: 5.214

4.  Reliable pace termination of postoperative atrial fibrillation in the canine sterile pericarditis model: Implications for atypical atrial flutter.

Authors:  Seungyup Lee; Sergey Vitebskiy; Robert N Goldstein; Celeen M Khrestian; Albert L Waldo
Journal:  Heart Rhythm O2       Date:  2022-01-13

Review 5.  Inflammatory signalling in atrial cardiomyocytes: a novel unifying principle in atrial fibrillation pathophysiology.

Authors:  Dobromir Dobrev; Stanley Nattel; Jordi Heijman; Roddy Hiram; Na Li
Journal:  Nat Rev Cardiol       Date:  2022-09-15       Impact factor: 49.421

  5 in total

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