Arrhythmogenic Potential of Pulmonary Venous Tissue: Triggers for Atrial Fibrillation Identified within the Remnant of a Vein

2009 ◽  
Vol 20 (4) ◽  
pp. 441-444 ◽  
Author(s):  
SANJAY DIXIT ◽  
WILLIAM H. SAUER ◽  
DAVID J. CALLANS ◽  
FRANCIS E. MARCHLINSKI
Keyword(s):  
Atrial Fibrillation ◽  
Arrhythmogenic Potential ◽  
Venous Tissue

Endocardial impedance mapping during circumferential pulmonary vein ablation of atrial fibrillation differentiates between atrial and venous tissue

Heart Rhythm ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 171-178 ◽  
Author(s):  
Christopher C.E. Lang ◽  
Filippo Gugliotta ◽  
Vincenzo Santinelli ◽  
Cézar Mesas ◽  
Takeshi Tomita ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Ablation ◽  
Venous Tissue

scholarly journals Neuromodulation targets intrinsic cardiac neurons to attenuate neuronally mediated atrial arrhythmias

2012 ◽  
Vol 302 (3) ◽  
pp. R357-R364 ◽  
Author(s):  
David D. Gibbons ◽  
E. Marie Southerland ◽  
Donald B. Hoover ◽  
Eric Beaumont ◽  
J. Andrew Armour ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Neuronal Activity ◽  
Superior Vena ◽  
Vena Cava ◽  
Fold Increase ◽  
Right Atrial ◽  
Atrial Arrhythmias ◽  
Local Circuit ◽  
Efferent Neurons ◽  
Arrhythmogenic Potential

Our objective was to determine whether atrial fibrillation (AF) results from excessive activation of intrinsic cardiac neurons (ICNs) and, if so, whether select subpopulations of neurons therein represent therapeutic targets for suppression of this arrhythmogenic potential. Trains of five electrical stimuli (0.3–1.2 mA, 1 ms) were delivered during the atrial refractory period to mediastinal nerves (MSN) on the superior vena cava to evoke AF. Neuroanatomical studies were performed by injecting the neuronal tracer DiI into MSN sites that induced AF. Functional studies involved recording of neuronal activity in situ from the right atrial ganglionated plexus (RAGP) in response to MSN stimulation (MSNS) prior to and following neuromodulation involving either preemptive spinal cord stimulation (SCS; T1–T3, 50 Hz, 200-ms duration) or ganglionic blockade (hexamethonium, 5 mg/kg). The tetramethylindocarbocyanine perchlorate (DiI) neuronal tracer labeled a subset (13.2%) of RAGP neurons, which also colocalized with cholinergic or adrenergic markers. A subset of DiI-labeled RAGP neurons were noncholinergic/nonadrenergic. MSNS evoked an ∼4-fold increase in RAGP neuronal activity from baseline, which SCS reduced by 43%. Hexamethonium blocked MSNS-evoked increases in neuronal activity. MSNS evoked AF in 78% of right-sided MSN sites, which SCS reduced to 33% and hexamethonium reduced to 7%. MSNS-induced bradycardia was maintained with SCS but was mitigated by hexamethonium. We conclude that MSNS activates subpopulations of intrinsic cardiac neurons, thereby resulting in the formation of atrial arrhythmias leading to atrial fibrillation. Stabilization of ICN local circuit neurons by SCS or the local circuit and autonomic efferent neurons with hexamethonium reduces the arrhythmogenic potential.

Cardiac arrhythmias and cancer therapies

ESC CardioMed ◽  
2018 ◽  
pp. 1181-1184
Author(s):  
John Keaney
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Toxic Effect ◽  
Cancer Patients ◽  
Cardiac Arrhythmias ◽  
Cancer Therapies ◽  
Direct Toxic Effect ◽  
Arrhythmogenic Potential ◽  
Thoracic Malignancies ◽  
Case Basis

There is an increasing awareness of the arrhythmogenic potential of cancer therapies, and the challenges they create in treating patients. As in the general population, the arrhythmia most frequently observed in patients undergoing cancer treatment is atrial fibrillation. Atrial fibrillation may occur as a result of the proinflammatory state of cancer, postoperatively (particularly in thoracic malignancies), or as a direct toxic effect of the chemotherapeutic agent. Cancer patients with atrial fibrillation may often have an increase in both thromboembolic and haemorrhagic risk. Therefore, the risks and benefits of anticoagulation should be carefully considered on a case-by-case basis.

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