title: Glycogen and the propensity for atrial fibrillation: intrinsic anatomic differences in glycogen in the left and right atria in the goat heart.
abstract: BACKGROUND
  Previous experimental studies have demonstrated electrophysiological and structural remodeling in pacing induced atrial fibrillation. The latter has been characterized by glycogen accumulation but no connection to atrial fibrillation induction and maintenance has as yet been proposed.
  
  
  OBJECTIVE
  We determined the presence of glycogen in the right and left atrial appendages in the goat heart, in order to find any intrinsic disparity in distribution and concentration between these sites.
  
  
  METHODS
  Atrial appendages from 5 goats were stained by the Periodic acid Schiffmethod to determine the presence of glycogen and the concentration of glycogen by morphometric analysis.
  
  
  RESULTS
  We are reporting for the first time that the right atrial appendage showed scattered glycogen granules throughout the atrial myocytes which delineated the intercalated discs; whereas glycogen in the left atrial appendage was more dense within cells and coalesced against the intercalated discs and side to side junctions between myocytes. Also, morphometric analysis determined that the stained regions of the right atrial appendages averaged, 0.8 ± 1.3 μm(2) compared to the left atrial appendage sections, 2.6 ± 3 μm(2), P = 0.02. We show that glycogen is heterogeneously distributed in both atria in the normal goat heart; however, the density of glycogen deposits concentrating against the intercalated discs and side to side connections in the left atrial appendage is a critically distinct difference. Impediment of cell to cell conduction could result in a non-uniform wavefront of activation, with areas of slowed conduction, predisposing the left atrium to reentrant based atrial fibrillation.
  
  
  CONCLUSIONS
  These findings provide a basis for the well-known greater propensity for atrial fibrillation in the left versus the right atrium.
authors.affiliation: Independent, Miami, Florida, USA.
authors.forename: Abraham A
authors.initials: AA
authors.lastname: Embi
authors.affiliation: Heart Rhythm Institute, University of Oklahoma Health Science Center, Professor of Medicine, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Scherlag
authors.affiliation: Professor of Pathology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater Oklahoma, USA.
authors.forename: Jerry W
authors.initials: JW
authors.lastname: Ritchey
keywords: Atrial appendages; activation wavefront; atrial conduction; atrial fibrillation; glycogen concentration; glycogen distribution