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Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long‐Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of “AF Begets AF”
BACKGROUND: Botulinum toxin (BTX), temporarily suppressing cholinergic transmission (<3 weeks), has been reported to suppress atrial fibrillation (AF) for ≥1 year. We aimed to investigate the mechanism underlying long‐term suppression of AF caused by injecting BTX into major atrial ganglionated p...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015371/ https://www.ncbi.nlm.nih.gov/pubmed/27381759 http://dx.doi.org/10.1161/JAHA.116.003309 |
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author | Lo, Li‐Wei Chang, Hung‐Yu Scherlag, Benjamin J. Lin, Yenn‐Jiang Chou, Yu‐Hui Lin, Wei‐Lun Chen, Shih‐Ann Po, Sunny S. |
author_facet | Lo, Li‐Wei Chang, Hung‐Yu Scherlag, Benjamin J. Lin, Yenn‐Jiang Chou, Yu‐Hui Lin, Wei‐Lun Chen, Shih‐Ann Po, Sunny S. |
author_sort | Lo, Li‐Wei |
collection | PubMed |
description | BACKGROUND: Botulinum toxin (BTX), temporarily suppressing cholinergic transmission (<3 weeks), has been reported to suppress atrial fibrillation (AF) for ≥1 year. We aimed to investigate the mechanism underlying long‐term suppression of AF caused by injecting BTX into major atrial ganglionated plexi (GPs). METHODS AND RESULTS: Bilateral thoracotomies in anesthetized dogs allowed programmed stimulation at 4 pulmonary veins, biatrial appendages, and the superior vena cava to determine the effective refractory period (ERP) in the first operation. Group 1 (n=10) received BTX injection into all GPs; group 2 (n=7) received no injection. Groups 1 and 2 received rapid atrial pacing (800 bpm) 6 days a week. Group 3 (n=7) did not undergo thoracotomy or rapid atrial pacing to serve as controls for histological studies. A second operation and the same measurements were made 3 months later. During the first operation in group 1, ERPs of 4 pulmonary veins, but not biatrial appendages or superior vena cava, increased immediately after BTX injection. AF burdens increased significantly from the fifth week after the first operation in group 2 but not in group 1. In the second operation, ERPs remained unchanged compared with ERPs before BTX injection in group 1, whereas ERPs shortened significantly at all sites except the superior vena cava in group 2. There was no difference of autonomic nerve density between group 1 and group 3. The GP choline acetyltransferase (+) and atrial tyrosine hydroxylase (+) nerve densities were higher in group 2 than in group 1 and group 3. CONCLUSIONS: Temporary suppression of major atrial GPs by BTX prevents autonomic remodeling and provides long‐term suppression of AF, indicating the critical role of GPs in AF progression. |
format | Online Article Text |
id | pubmed-5015371 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-50153712016-09-19 Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long‐Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of “AF Begets AF” Lo, Li‐Wei Chang, Hung‐Yu Scherlag, Benjamin J. Lin, Yenn‐Jiang Chou, Yu‐Hui Lin, Wei‐Lun Chen, Shih‐Ann Po, Sunny S. J Am Heart Assoc Original Research BACKGROUND: Botulinum toxin (BTX), temporarily suppressing cholinergic transmission (<3 weeks), has been reported to suppress atrial fibrillation (AF) for ≥1 year. We aimed to investigate the mechanism underlying long‐term suppression of AF caused by injecting BTX into major atrial ganglionated plexi (GPs). METHODS AND RESULTS: Bilateral thoracotomies in anesthetized dogs allowed programmed stimulation at 4 pulmonary veins, biatrial appendages, and the superior vena cava to determine the effective refractory period (ERP) in the first operation. Group 1 (n=10) received BTX injection into all GPs; group 2 (n=7) received no injection. Groups 1 and 2 received rapid atrial pacing (800 bpm) 6 days a week. Group 3 (n=7) did not undergo thoracotomy or rapid atrial pacing to serve as controls for histological studies. A second operation and the same measurements were made 3 months later. During the first operation in group 1, ERPs of 4 pulmonary veins, but not biatrial appendages or superior vena cava, increased immediately after BTX injection. AF burdens increased significantly from the fifth week after the first operation in group 2 but not in group 1. In the second operation, ERPs remained unchanged compared with ERPs before BTX injection in group 1, whereas ERPs shortened significantly at all sites except the superior vena cava in group 2. There was no difference of autonomic nerve density between group 1 and group 3. The GP choline acetyltransferase (+) and atrial tyrosine hydroxylase (+) nerve densities were higher in group 2 than in group 1 and group 3. CONCLUSIONS: Temporary suppression of major atrial GPs by BTX prevents autonomic remodeling and provides long‐term suppression of AF, indicating the critical role of GPs in AF progression. John Wiley and Sons Inc. 2016-07-05 /pmc/articles/PMC5015371/ /pubmed/27381759 http://dx.doi.org/10.1161/JAHA.116.003309 Text en © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) 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 | Original Research Lo, Li‐Wei Chang, Hung‐Yu Scherlag, Benjamin J. Lin, Yenn‐Jiang Chou, Yu‐Hui Lin, Wei‐Lun Chen, Shih‐Ann Po, Sunny S. Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long‐Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of “AF Begets AF” |
title | Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long‐Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of “AF Begets AF” |
title_full | Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long‐Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of “AF Begets AF” |
title_fullStr | Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long‐Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of “AF Begets AF” |
title_full_unstemmed | Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long‐Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of “AF Begets AF” |
title_short | Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long‐Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of “AF Begets AF” |
title_sort | temporary suppression of cardiac ganglionated plexi leads to long‐term suppression of atrial fibrillation: evidence of early autonomic intervention to break the vicious cycle of “af begets af” |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015371/ https://www.ncbi.nlm.nih.gov/pubmed/27381759 http://dx.doi.org/10.1161/JAHA.116.003309 |
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