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A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas

INTRODUCTION: The ganglionated plexuses (GPs) of the intrinsic cardiac autonomic system are implicated in arrhythmogenesis. GP localization by stimulation of the epicardial fat pads to produce atrioventricular dissociating (AVD) effects is well described. We determined the anatomical distribution of...

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Autores principales: Kim, Min‐Young, Sikkel, Markus B., Hunter, Ross J., Haywood, Guy A., Tomlinson, David R., Tayebjee, Muzahir H., Ali, Rheeda L., Cantwell, Chris D., Gonna, Hanney, Sandler, Belinda C., Lim, Elaine, Furniss, Guy, Panagopoulos, Dimitrios, Begg, Gordon, Dhillon, Gurpreet, Hill, Nicola J., O’Neill, James, Francis, Darrel P., Lim, Phang Boon, Peters, Nicholas S., Linton, Nick W. F., Kanagaratnam, Prapa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369684/
https://www.ncbi.nlm.nih.gov/pubmed/30168232
http://dx.doi.org/10.1111/jce.13723
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author Kim, Min‐Young
Sikkel, Markus B.
Hunter, Ross J.
Haywood, Guy A.
Tomlinson, David R.
Tayebjee, Muzahir H.
Ali, Rheeda L.
Cantwell, Chris D.
Gonna, Hanney
Sandler, Belinda C.
Lim, Elaine
Furniss, Guy
Panagopoulos, Dimitrios
Begg, Gordon
Dhillon, Gurpreet
Hill, Nicola J.
O’Neill, James
Francis, Darrel P.
Lim, Phang Boon
Peters, Nicholas S.
Linton, Nick W. F.
Kanagaratnam, Prapa
author_facet Kim, Min‐Young
Sikkel, Markus B.
Hunter, Ross J.
Haywood, Guy A.
Tomlinson, David R.
Tayebjee, Muzahir H.
Ali, Rheeda L.
Cantwell, Chris D.
Gonna, Hanney
Sandler, Belinda C.
Lim, Elaine
Furniss, Guy
Panagopoulos, Dimitrios
Begg, Gordon
Dhillon, Gurpreet
Hill, Nicola J.
O’Neill, James
Francis, Darrel P.
Lim, Phang Boon
Peters, Nicholas S.
Linton, Nick W. F.
Kanagaratnam, Prapa
author_sort Kim, Min‐Young
collection PubMed
description INTRODUCTION: The ganglionated plexuses (GPs) of the intrinsic cardiac autonomic system are implicated in arrhythmogenesis. GP localization by stimulation of the epicardial fat pads to produce atrioventricular dissociating (AVD) effects is well described. We determined the anatomical distribution of the left atrial GPs that influence atrioventricular (AV) dissociation. METHODS AND RESULTS: High frequency stimulation was delivered through a Smart‐Touch catheter in the left atrium of patients undergoing atrial fibrillation (AF) ablation. Three dimensional locations of points tested throughout the entire chamber were recorded on the CARTO™ system. Impact on the AV conduction was categorized as ventricular asystole, bradycardia, or no effect. CARTO maps were exported, registered, and transformed onto a reference left atrial geometry using a custom software, enabling data from multiple patients to be overlaid. In 28 patients, 2108 locations were tested and 283 sites (13%) demonstrated (AVD‐GP) effects. There were 10 AVD‐GPs (interquartile range, 11.5) per patient. Eighty percent (226) produced asystole and 20% (57) showed bradycardia. The distribution of the two groups was very similar. Highest probability of AVD‐GPs (>20%) was identified in: inferoseptal portion (41%) and right inferior pulmonary vein base (30%) of the posterior wall, right superior pulmonary vein antrum (31%). CONCLUSION: It is feasible to map the entire left atrium for AVD‐GPs before AF ablation. Aggregated data from multiple patients, producing a distribution probability atlas of AVD‐GPs, identified three regions with a higher likelihood for finding AVD‐GPs and these matched the histological descriptions. This approach could be used to better characterize the autonomic network.
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spelling pubmed-63696842019-02-21 A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas Kim, Min‐Young Sikkel, Markus B. Hunter, Ross J. Haywood, Guy A. Tomlinson, David R. Tayebjee, Muzahir H. Ali, Rheeda L. Cantwell, Chris D. Gonna, Hanney Sandler, Belinda C. Lim, Elaine Furniss, Guy Panagopoulos, Dimitrios Begg, Gordon Dhillon, Gurpreet Hill, Nicola J. O’Neill, James Francis, Darrel P. Lim, Phang Boon Peters, Nicholas S. Linton, Nick W. F. Kanagaratnam, Prapa J Cardiovasc Electrophysiol Original Articles INTRODUCTION: The ganglionated plexuses (GPs) of the intrinsic cardiac autonomic system are implicated in arrhythmogenesis. GP localization by stimulation of the epicardial fat pads to produce atrioventricular dissociating (AVD) effects is well described. We determined the anatomical distribution of the left atrial GPs that influence atrioventricular (AV) dissociation. METHODS AND RESULTS: High frequency stimulation was delivered through a Smart‐Touch catheter in the left atrium of patients undergoing atrial fibrillation (AF) ablation. Three dimensional locations of points tested throughout the entire chamber were recorded on the CARTO™ system. Impact on the AV conduction was categorized as ventricular asystole, bradycardia, or no effect. CARTO maps were exported, registered, and transformed onto a reference left atrial geometry using a custom software, enabling data from multiple patients to be overlaid. In 28 patients, 2108 locations were tested and 283 sites (13%) demonstrated (AVD‐GP) effects. There were 10 AVD‐GPs (interquartile range, 11.5) per patient. Eighty percent (226) produced asystole and 20% (57) showed bradycardia. The distribution of the two groups was very similar. Highest probability of AVD‐GPs (>20%) was identified in: inferoseptal portion (41%) and right inferior pulmonary vein base (30%) of the posterior wall, right superior pulmonary vein antrum (31%). CONCLUSION: It is feasible to map the entire left atrium for AVD‐GPs before AF ablation. Aggregated data from multiple patients, producing a distribution probability atlas of AVD‐GPs, identified three regions with a higher likelihood for finding AVD‐GPs and these matched the histological descriptions. This approach could be used to better characterize the autonomic network. John Wiley and Sons Inc. 2018-10-05 2018-12 /pmc/articles/PMC6369684/ /pubmed/30168232 http://dx.doi.org/10.1111/jce.13723 Text en © 2018 The Authors. Journal of Cardiovascular Electrophysiology Published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Kim, Min‐Young
Sikkel, Markus B.
Hunter, Ross J.
Haywood, Guy A.
Tomlinson, David R.
Tayebjee, Muzahir H.
Ali, Rheeda L.
Cantwell, Chris D.
Gonna, Hanney
Sandler, Belinda C.
Lim, Elaine
Furniss, Guy
Panagopoulos, Dimitrios
Begg, Gordon
Dhillon, Gurpreet
Hill, Nicola J.
O’Neill, James
Francis, Darrel P.
Lim, Phang Boon
Peters, Nicholas S.
Linton, Nick W. F.
Kanagaratnam, Prapa
A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas
title A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas
title_full A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas
title_fullStr A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas
title_full_unstemmed A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas
title_short A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas
title_sort novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369684/
https://www.ncbi.nlm.nih.gov/pubmed/30168232
http://dx.doi.org/10.1111/jce.13723
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