Efficacy of sequential ablation of sinus atrial node fat pad and atrialventricular node fat pad on inducibility of atrial fibrillation evoked by vagus trunk stimulation
10.3760/cma.j.issn.0253-3758.2011.12.003
- VernacularTitle:序列消融犬窦房结脂肪垫和房室结脂肪垫对迷走神经介导心房颤动诱发的影响
- Author:
Qi-Na ZHOU
1
;
Xiao-Qin ZHANG
;
Ling ZHANG
;
Shang-Lei YANG
;
Hua CHEN
;
Yan-Hong MA
;
Wei SONG
;
Yue-Mei HOU
Author Information
1. 新疆医科大学第一附属医院
- Keywords:
Atrial fibrillation;
Catheter ablation;
Vagus nerve;
Adipose tissue
- From:
Chinese Journal of Cardiology
2011;39(12):1088-1093
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of sequential ablation of epicardial fat pad on inducibility of atrial fibrillation (AF) evoked by stimulating vagus trunk.Methods Eighteen adult mongrel dogs were randomly divided into 2 groups (n =9 each):Group A underwent pre-ablation of sinus-atrial node fad pad (SANFP) and subsequent ablation of atria-ventricular node fad pad (AVNFP).Group B underwent pre-ablation of AVNFP and subsequent ablation of SANFP.AF was induced by high-frequency electrical stimulation of bilateral vagus trunks.The AF inducibility and effective refractory period (ERP) changes during vagus trunk stimulation were examined before and after ablation in atria and pulmonary veins.Results (1) AF could be induced by vagus trunk stimulation and the incidence was higher during right vagus trunk (RVG) stimulation than left vagus trunk (LVG) stimulation [ (60.0 ± 0.0) ％ vs ( 18.4 ± 22.1 ) ％ ].(2)SANFP ablation significantly attenuated AF inducibility with LVG stimulation and RVG stimulation at 2 V (decreased 67.0％ and 72.0％,respectively).Subsequent AVNFP ablation after SANFP ablation further reduced AF inducibility with LVG and RVG stimulation at 2 V (decreased 100.0％ and 95.5％,respectively).(3)AVNFP ablation (decreased 95.7％ and 96.3％,respectively) and subsequent SANFP ablation after AVNFP ablation ( decreased 98.0％ and 100.0％,respectively) significantly attenuated AF inducibility with LVG stimulation and RVG stimulation at 2V.(4) Vagal stimulation induced ERP shortening was significantly attenuated by isolated SANFP ablation or AVNFP.Subsequent AVNFP ablation after SANFP induced significant ERP shortening in right atrial site compared with isolated SANFP ablation.However,changes of ERP shortening were similar between AVNFP ablation and subsequent SANFP ablation after AVNFP ablation.Conclusions Epicardial fat pad ablation reduced the AF inducibility and prolonged ERP of atria and pulmonary veins during vagus trunk stimulation.AVNFP,as the “ integration centers”modulating the vagal innervation to the atria,may be the more effective target of ablation for treating AF.
