Electrophysiological Differences between the Epicardium and the Endocardium of the Left Atrium
Por:
Michowitz, Y, Nakahara, S, Bourke, T, Buch, E, Vaseghi, M, De Diego, C, Wiener, I, Mahajan, A and Shivkumar, K
Publicada:
1 ene 2011
Resumen:
Methods and Results: Transseptal endocardial and percutaneous epicardial mapping were performed in a porcine model (n = 7). Two opposing 4-mm electrophysiological catheters were positioned endocardially and epicardially. A circular mapping catheter (CMC) was positioned at the ostium of the common inferior pulmonary vein (CIPV) recording left atrial (LA)-PV potentials. Endocardial and epicardial effective refractory periods (ERPs) at two basic cycle lengths (CLs) of 600 and 400 ms were recorded from four anatomic locations (CIPV, LA appendage, right superior PV, and LA posterior wall). Atrial repetitive response (ARR) induction was also tested from endocardial and epicardial sites. Overall, 254 ERP measurements (mean 36.3 per animal) and 84 induction attempts (mean 12 per animal) were performed. The ERP was significantly shorter in the epicardium compared to the endocardium at basic CL of 400 ms (P = 0.006) but not at CL of 600 ms (P = 0.2). In addition, only the epicardium demonstrated ERP shortening when the CL of the basic drive was shortened (P = 0.03). ARR could be induced more often from the epicardium (P = 0.002) and fibrillatory activity with epicardial/endocardial dissociation was recorded (n = 3). Also, the earliest PV activation site on the CMC was noted to be different in 16.5% of cases during epicardial and endocardial pacing.
Conclusion: The electrophysiological characteristics of the atrial epicardium are different from the endocardium with a shorter ERP and more frequent ARR induction by programed stimulation. (PACE 2011; 37-46).
Filiaciones:
Michowitz, Y:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
Nakahara, S:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
Bourke, T:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
Buch, E:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
Vaseghi, M:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
Wiener, I:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
Mahajan, A:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
Shivkumar, K:
Univ Calif Los Angeles, David Geffen Sch Med, UCLA Cardiac Arrhythmia Ctr, Ronald Reagan UCLA Med Ctr, Los Angeles, CA 90095 USA
Green Accepted
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