Epicardial ablation of right pulmonary artery ganglionated plexi for the prevention of atrial fibrillation originating in the pulmonary veins.
PROBLEM PRESENTED: A novel study of catheter ablation of the right pulmonary artery ganglionated plexi (RPA GP) to reduce atrial fibrillation (AF) originating in the pulmonary veins (PVs) is presented.
In 20 dogs, atrial effective refractory periods (AERPs), PVERP, and the dispersion of AERP (dAERP) were measured at baseline during RPA GP stimulation and after ablation. Programmed stimulation and burst stimulation protocols were performed at 4 distal PVs to measure the percentage of AF induced before and after ablation.


RESULTS
Stimulation of the RPA GP shortened AERP (116 +/- 16 vs 130 +/- 10 milliseconds, P < .01) and PVERP (122 +/- 14 vs 136 +/- 12 milliseconds, P < .01), and increased dAERP (31 +/- 6 vs 23 +/- 6 milliseconds, P < .01). However, the above indices revealed an adverse change after excision (AERP, 138 +/- 7 vs 130 +/- 10 milliseconds; PVERP, 146 +/- 18 vs 136 +/- 12 milliseconds; and dAERP, 19 +/- 5 vs 23 +/- 6 milliseconds; P < .05). Furthermore, the percentage of AF induced from PVs was significantly reduced with vagosympathetic stimulation (40% vs 90%, P < .01).


CONCLUSIONS
Ablation of the RPA GP changes the electrophysiologic properties of both the atria and the PVs and decreases AF inducibility arising from the PVs.
Wang
Hongtao
H
Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Baqiao District, Xi'an City, Shaanxi, China.
Li
Jun
J
Hong
Changming
C
Liu
Xiongtao
X
Shang
Fujun
F
He
Yong
Y
Wang
Zikuan
Z
Zheng
Qiangsun
Q
D000818:Animals; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control*; D017115:Catheter Ablation; D004285:Dogs; D005260:Female; D005726:Ganglia, Parasympathetic / Q000503:physiopathology / Q000601:surgery; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D010496:Pericardium / Q000503:physiopathology / Q000601:surgery*; D011651:Pulmonary Artery / Q000601:surgery*; D011667:Pulmonary Veins / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome