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Identification of Left Atrial Ganglionated Plexi by Dense Epicardial Mapping as Ablation Targets for the Treatment of Concomitant Atrial Fibrillation

BACKGROUND: Autonomic ganglionated plexi (GPs) play a significant role in the initiation and maintenance of atrial fibrillation (AF). GPs are key targets for a maze procedure. The purpose of this study was to identify the location of the left atrial GPs based on dense epicardial mapping during a maz...

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Autores principales: Kondo, Yusuke, Ueda, Marehiko, Watanabe, Michiko, Ishimura, Masayuki, Kajiyama, Takatsugu, Hashiguchi, Naotaka, Kanaeda, Tomonori, Nakano, Masahiro, Hiranuma, Yasunori, Ishizaka, Toru, Matsumiya, Goro, Kobayashi, Yoshio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BlackWell Publishing Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285812/
https://www.ncbi.nlm.nih.gov/pubmed/23742214
http://dx.doi.org/10.1111/pace.12169
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author Kondo, Yusuke
Ueda, Marehiko
Watanabe, Michiko
Ishimura, Masayuki
Kajiyama, Takatsugu
Hashiguchi, Naotaka
Kanaeda, Tomonori
Nakano, Masahiro
Hiranuma, Yasunori
Ishizaka, Toru
Matsumiya, Goro
Kobayashi, Yoshio
author_facet Kondo, Yusuke
Ueda, Marehiko
Watanabe, Michiko
Ishimura, Masayuki
Kajiyama, Takatsugu
Hashiguchi, Naotaka
Kanaeda, Tomonori
Nakano, Masahiro
Hiranuma, Yasunori
Ishizaka, Toru
Matsumiya, Goro
Kobayashi, Yoshio
author_sort Kondo, Yusuke
collection PubMed
description BACKGROUND: Autonomic ganglionated plexi (GPs) play a significant role in the initiation and maintenance of atrial fibrillation (AF). GPs are key targets for a maze procedure. The purpose of this study was to identify the location of the left atrial GPs based on dense epicardial mapping during a maze procedure in patients with concomitant AF. METHODS: Sixteen patients (age, 68 ± 10 years; 11 males, 69%) with heart failure and concomitant AF (duration 55 ± 86 months) underwent intraoperative epicardial electrophysiological mapping and a GP ablation using the maze procedure at our institution. Twenty-four-site, high-frequency stimulation (1,000/min; output, 18 V; pulse width, 0.75 ms) was performed by placing tweezers directly onto the potential GP sites on the left atrial epicardium. RESULTS: Active GPs were found in 13 (81%) of the 16 patients, and 12 (92%) of 13 patients had active GPs between the right pulmonary veins (PVs) and the interatrial groove. For those patients with active locations, a 7-day event-loop recording demonstrated that 12 (92%) of 13 patients were maintained in sinus rhythm 3 months after the operation. CONCLUSION: Dense epicardial mapping in the potential GP areas identified active GP locations in a high percentage of patients. GPs between the PVs and interatrial groove have a high potential as ablation targets for treatment of concomitant AF.
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spelling pubmed-42858122015-01-14 Identification of Left Atrial Ganglionated Plexi by Dense Epicardial Mapping as Ablation Targets for the Treatment of Concomitant Atrial Fibrillation Kondo, Yusuke Ueda, Marehiko Watanabe, Michiko Ishimura, Masayuki Kajiyama, Takatsugu Hashiguchi, Naotaka Kanaeda, Tomonori Nakano, Masahiro Hiranuma, Yasunori Ishizaka, Toru Matsumiya, Goro Kobayashi, Yoshio Pacing Clin Electrophysiol Electrophysiology BACKGROUND: Autonomic ganglionated plexi (GPs) play a significant role in the initiation and maintenance of atrial fibrillation (AF). GPs are key targets for a maze procedure. The purpose of this study was to identify the location of the left atrial GPs based on dense epicardial mapping during a maze procedure in patients with concomitant AF. METHODS: Sixteen patients (age, 68 ± 10 years; 11 males, 69%) with heart failure and concomitant AF (duration 55 ± 86 months) underwent intraoperative epicardial electrophysiological mapping and a GP ablation using the maze procedure at our institution. Twenty-four-site, high-frequency stimulation (1,000/min; output, 18 V; pulse width, 0.75 ms) was performed by placing tweezers directly onto the potential GP sites on the left atrial epicardium. RESULTS: Active GPs were found in 13 (81%) of the 16 patients, and 12 (92%) of 13 patients had active GPs between the right pulmonary veins (PVs) and the interatrial groove. For those patients with active locations, a 7-day event-loop recording demonstrated that 12 (92%) of 13 patients were maintained in sinus rhythm 3 months after the operation. CONCLUSION: Dense epicardial mapping in the potential GP areas identified active GP locations in a high percentage of patients. GPs between the PVs and interatrial groove have a high potential as ablation targets for treatment of concomitant AF. BlackWell Publishing Ltd 2013-11 2013-06-06 /pmc/articles/PMC4285812/ /pubmed/23742214 http://dx.doi.org/10.1111/pace.12169 Text en ©2013 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals, Inc. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Electrophysiology
Kondo, Yusuke
Ueda, Marehiko
Watanabe, Michiko
Ishimura, Masayuki
Kajiyama, Takatsugu
Hashiguchi, Naotaka
Kanaeda, Tomonori
Nakano, Masahiro
Hiranuma, Yasunori
Ishizaka, Toru
Matsumiya, Goro
Kobayashi, Yoshio
Identification of Left Atrial Ganglionated Plexi by Dense Epicardial Mapping as Ablation Targets for the Treatment of Concomitant Atrial Fibrillation
title Identification of Left Atrial Ganglionated Plexi by Dense Epicardial Mapping as Ablation Targets for the Treatment of Concomitant Atrial Fibrillation
title_full Identification of Left Atrial Ganglionated Plexi by Dense Epicardial Mapping as Ablation Targets for the Treatment of Concomitant Atrial Fibrillation
title_fullStr Identification of Left Atrial Ganglionated Plexi by Dense Epicardial Mapping as Ablation Targets for the Treatment of Concomitant Atrial Fibrillation
title_full_unstemmed Identification of Left Atrial Ganglionated Plexi by Dense Epicardial Mapping as Ablation Targets for the Treatment of Concomitant Atrial Fibrillation
title_short Identification of Left Atrial Ganglionated Plexi by Dense Epicardial Mapping as Ablation Targets for the Treatment of Concomitant Atrial Fibrillation
title_sort identification of left atrial ganglionated plexi by dense epicardial mapping as ablation targets for the treatment of concomitant atrial fibrillation
topic Electrophysiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285812/
https://www.ncbi.nlm.nih.gov/pubmed/23742214
http://dx.doi.org/10.1111/pace.12169
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