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Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin

BACKGROUND AND OBJECTIVES: Major epicardial fat pads contain cardiac ganglionated plexi (GP) of the autonomic nervous system. Autonomic denervation may improve the success rate of atrial fibrillation (AF) ablation. This study was designed to elucidate the acute effects of blocking the right atrium-p...

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Autores principales: Oh, Seil, Choi, Eue-Keun, Choi, Yun-Shik
Formato: Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933463/
https://www.ncbi.nlm.nih.gov/pubmed/20830252
http://dx.doi.org/10.4070/kcj.2010.40.8.387
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author Oh, Seil
Choi, Eue-Keun
Choi, Yun-Shik
author_facet Oh, Seil
Choi, Eue-Keun
Choi, Yun-Shik
author_sort Oh, Seil
collection PubMed
description BACKGROUND AND OBJECTIVES: Major epicardial fat pads contain cardiac ganglionated plexi (GP) of the autonomic nervous system. Autonomic denervation may improve the success rate of atrial fibrillation (AF) ablation. This study was designed to elucidate the acute effects of blocking the right atrium-pulmonary vein (RA-PV) and left atrium-inferior vena cava (LA-IVC) fat pads on the electrophysiologic characteristics of the atrium and AF inducibility with a botulinum toxin injection. MATERIALS AND METHODS: Eight mongrel dogs were studied. The RA-PV and LA-IVC fat pads were exposed through a median thoracotomy. Botulinum toxin (BT, 50 U to each fat pad, n=6) or normal saline (NS, n=2) was injected in the entire area of two fat pads. The study protocol was applied before injection and repeated at 1, 2, 3, 4, and 5 hours thereafter. The sinus rate, ventricular rate during rapid atrial pacing with a cycle length of 50 ms, and AF inducibility were measured with and without vagal stimulation (VS). Bilateral cervical VS was applied (20 Hz, 0.2 ms, 5.6±2.0 V). AF inducibility was evaluated with burst pacing with 200 impulses at a 50-ms cycle length. RESULTS: VS effects on the sinus node and AF inducibility were eliminated a few hours after injection of BT; these changes were not observed after injection of NS. CONCLUSION: Short-term autonomic denervation of the atria was achieved by blocking the major epicardial GP with BT.
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spelling pubmed-29334632010-09-09 Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin Oh, Seil Choi, Eue-Keun Choi, Yun-Shik Korean Circ J Original Article BACKGROUND AND OBJECTIVES: Major epicardial fat pads contain cardiac ganglionated plexi (GP) of the autonomic nervous system. Autonomic denervation may improve the success rate of atrial fibrillation (AF) ablation. This study was designed to elucidate the acute effects of blocking the right atrium-pulmonary vein (RA-PV) and left atrium-inferior vena cava (LA-IVC) fat pads on the electrophysiologic characteristics of the atrium and AF inducibility with a botulinum toxin injection. MATERIALS AND METHODS: Eight mongrel dogs were studied. The RA-PV and LA-IVC fat pads were exposed through a median thoracotomy. Botulinum toxin (BT, 50 U to each fat pad, n=6) or normal saline (NS, n=2) was injected in the entire area of two fat pads. The study protocol was applied before injection and repeated at 1, 2, 3, 4, and 5 hours thereafter. The sinus rate, ventricular rate during rapid atrial pacing with a cycle length of 50 ms, and AF inducibility were measured with and without vagal stimulation (VS). Bilateral cervical VS was applied (20 Hz, 0.2 ms, 5.6±2.0 V). AF inducibility was evaluated with burst pacing with 200 impulses at a 50-ms cycle length. RESULTS: VS effects on the sinus node and AF inducibility were eliminated a few hours after injection of BT; these changes were not observed after injection of NS. CONCLUSION: Short-term autonomic denervation of the atria was achieved by blocking the major epicardial GP with BT. The Korean Society of Cardiology 2010-08 2010-08-31 /pmc/articles/PMC2933463/ /pubmed/20830252 http://dx.doi.org/10.4070/kcj.2010.40.8.387 Text en Copyright © 2010 The Korean Society of Cardiology http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Oh, Seil
Choi, Eue-Keun
Choi, Yun-Shik
Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin
title Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin
title_full Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin
title_fullStr Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin
title_full_unstemmed Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin
title_short Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin
title_sort short-term autonomic denervation of the atria using botulinum toxin
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933463/
https://www.ncbi.nlm.nih.gov/pubmed/20830252
http://dx.doi.org/10.4070/kcj.2010.40.8.387
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