Long‐Term Effects of Atrial Ganglionated Plexi Ablation on Function and Structure of Sinoatrial and Atrioventricular Node in Canine

Zhang, Ming; Wang, Ximin; Xie, Xide; Wang, M M Zhongsu; Liu, Xiaoyan; Guan, Min; Wang, Weizong; Li, M M Zhan; Wang, Jiangrong; Gao, Mengchun; Hou, Yinglong

doi:10.1111/pace.12689

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…Another study by Wang et al similarly showed that EGPA increased atrial fibrillation inducibility and atrial neuron remodeling at 1‐, 6‐, 12‐month follow‐ups. They also observed that EGPA has short‐term effects on function and structure of sinoatrial/atrioventricular node rather than long‐term effects, suggesting that EGPA has good long‐term safety.…”

Section: Discussionmentioning

confidence: 99%

“…10 showed that EGPA increased atrial fibrillation inducibility and atrial neuron remodeling at 1-, 6-, 12-month follow-ups. They also observed that EGPA has short-term effects on function and structure of sinoatrial/atrioventricular node rather than long-term effects, 14 suggesting that EGPA has good long-term safety. In this study, we found that EGPA also significantly increased the inducibility of ventricular arrhythmia in this post-MI model.…”

Section: Effects Of Egpa In Noninfarcted Animalsmentioning

confidence: 99%

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Epicardial ganglionated plexi ablation increases the inducibility of ventricular tachyarrhythmias in a canine postmyocardial infarction model

Dai

et al. 2019

Cardiovasc electrophysiol

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Introduction Previous studies have shown that epicardial ganglionated plexi ablation (EGPA) could increase the risk of ventricular arrhythmias induced by acute myocardial ischemia. However, the long‐term effect of EGPA in a canine postmyocardial infarction (MI) model is not well established. Materials and Methods Twenty mongrel dogs were randomly divided into two groups: an MI group (n = 10) and an EGPA group (EGPA plus MI, n = 10). EGPA was achieved by ablation of four major ganglion plexi and the ligament of Marshall. The electrocardiograph (ECG) parameters, ventricular effective refractory period (ERP), inducibility of tachyarrhythmias, and ventricular fibrillation threshold (VFT) were measured at baseline and after 8 weeks. Tyrosine hydroxylase (TH) and nerve growth factor (NGF) expression levels in the peri‐infarcted zone were also determined by immunohistochemistry in both groups at the end of the study. Results No significant differences were found in electrophysiological parameters at the baseline between the two groups. At the end of the 8‐week follow‐up, however, the EGPA group was associated with a longer QT interval, corrected QT (QTc) interval and ventricular ERP, larger dispersion of QT, QTc, and ERP, and higher inducibility of tachyarrhythmia and VFT when compared to the MI group. In addition, the density of TH and NGF in the peri‐infarcted zone was also significantly increased in the EGPA group in comparison to the MI group. Conclusions After the 8‐week follow‐up, EGPA increased the ventricular arrhythmia inducibility in the canine post‐MI model, likely by increasing ventricular electrophysiological instability and promoting ventricular sympathetic remodeling.

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Section: Discussionmentioning

confidence: 99%

Section: Effects Of Egpa In Noninfarcted Animalsmentioning

confidence: 99%

Epicardial ganglionated plexi ablation increases the inducibility of ventricular tachyarrhythmias in a canine postmyocardial infarction model

Dai

et al. 2019

Cardiovasc electrophysiol

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Cryoballoon pulmonary vein isolation-mediated rise of sinus rate in patients with paroxysmal atrial fibrillation

et al. 2020

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Background Modulation of the cardiac autonomic nervous system by pulmonary vein isolation (PVI) influences the sinoatrial nodal rate. Little is known about the causes, maintenance and prognostic value of this phenomenon. We set out to explore the effects of cryoballoon PVI (cryo-PVI) on sinus rate and its significance for clinical outcome. Methods and results We evaluated 110 patients with paroxysmal atrial fibrillation (AF), who underwent PVI using a second-generation 28 mm cryoballoon by pre-, peri- and postprocedural heart rate acquisition and analysis of clinical outcome. Ninety-one patients could be included in postinterventional follow-up, indicating that cryo-PVI resulted in a significant rise of sinus rate by 16.5% (+ 9.8 ± 0.9 beats/min, p < 0.001) 1 day post procedure compared to preprocedural acquisition. This effect was more pronounced in patients with initial sinus bradycardia (< 60 beats/min.) compared to patients with faster heart rate. Increase of rate was primarily driven by ablation of the right superior pulmonary vein and for a subset of patients, in whom this could be assessed, persisted ≥ 1 year after the procedure. AF recurrence was neither predicted by the magnitude of the initial rate, nor by the extent of rate change, but postprocedural sinus bradycardia was associated with higher recurrence of AF in the year post PVI. Conclusions Cryo-PVI causes a significant rise of sinus rate that is more pronounced in subjects with previous sinus bradycardia. Patient follow-up indicates persistence of this effect and suggests an increased risk of AF recurrence in patients with postprocedural bradycardia. Graphic abstract Electronic supplementary material The online version of this article (10.1007/s00392-020-01659-0) contains supplementary material, which is available to authorized users.

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Effect on sinus cycle length and atrioventricular node function after high-power short-duration versus conventional radiofrequency catheter ablation in paroxysmal atrial fibrillation

Kim²,

Cho

et al. 2022

Int J Arrhythm

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Background The efficacy and safety of high-power, short-duration (HPSD) radiofrequency catheter ablation for atrial fibrillation (AF) have been demonstrated in several studies. We aimed to evaluate and compare the effects of the conventional method and the HPSD method for AF ablation on the sinus and AV node function in patients with paroxysmal AF. Methods The medical records of patients with paroxysmal AF who underwent pulmonary vein isolation (PVI) were retrieved from a prospectively collected AF ablation registry at a large-sized tertiary center. The HPSD group (n = 41) was distinguished from the conventional ablation group (n = 198) in terms of the power (50 W vs. 20–40 W) and duration (6–10 s vs. 20–30 s) of radiofrequency energy delivery during PVI. Peri-procedural changes in cardiac autonomy were assessed in terms of the changes in sinus cycle length (SCL), block cycle length (BCL), and effective refractory period (ERP) of the atrioventricular node (AVN). Results The SCL, BCL, and ERP of the AVN at baseline and post-ablation were not significantly different between the conventional ablation group and the HPSD group. Shortening of the SCL, BCL, and ERP of the AVN was observed immediately after AF ablation in both groups. One-year recurrence of AF/atrial flutter (35.1% vs. 20.3%; P = 0.011) and atrial flutter (13.8% vs. 4.7%; P = 0.015) were higher in the HPSD group than in the conventional ablation group. Conclusion Both the HPSD and the conventional ablation method resulted in post-ablation vagal modification as evidenced by the shortening of SCL, BCL, and ERP of the AVN. One-year recurrence of atrial flutter and AF/atrial flutter was higher in patients who underwent the HPSD method.

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Long‐Term Effects of Atrial Ganglionated Plexi Ablation on Function and Structure of Sinoatrial and Atrioventricular Node in Canine

Cited by 3 publications

References 31 publications

Epicardial ganglionated plexi ablation increases the inducibility of ventricular tachyarrhythmias in a canine postmyocardial infarction model

Epicardial ganglionated plexi ablation increases the inducibility of ventricular tachyarrhythmias in a canine postmyocardial infarction model

Cryoballoon pulmonary vein isolation-mediated rise of sinus rate in patients with paroxysmal atrial fibrillation

Effect on sinus cycle length and atrioventricular node function after high-power short-duration versus conventional radiofrequency catheter ablation in paroxysmal atrial fibrillation

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