Effect of autonomic neurotransmitters on excitable gap composition in canine atrial flutter

2001 ◽  
Vol 79 (1) ◽  
pp. 13-17
Author(s):  
Marc M Rahme ◽  
Elise Jalil ◽  
Martin Laflamme ◽  
Teresa Kus
Keyword(s):  
Atrial Flutter ◽  
Recovery Period ◽  
Safety Margin ◽  
Right Atrial ◽  
Constant Infusion ◽  
Anesthetized Dogs ◽  
Gap Characteristics ◽  
Excitable Gap ◽  
Right Atrial Appendage ◽  
The Right

Atrial arrhythmias are believed to be influenced by autonomic nervous system tone. We evaluated the effects of sympathetic and parasympathetic activation on atrial flutter (AFl) by determining the effects of norepinephrine (NE) and acetylcholine (ACh) on the composition of the excitable gap. A model of reentry around the tricuspid valve was produced in 17 chloralose anesthetized dogs using a Y-shaped lesion in the intercaval area that extended to the right atrial appendage. Excitable gap characteristics were determined during AFl by scanning diastole with a single premature extrastimulus at progressively shorter coupling intervals to define the reset-response curve. Measurements were made during a constant infusion of NE (15 µg/min) into the right coronary artery and repeated during ACh infusion (2 µg/min) following a 15 min recovery period. The excitable gap (27 ± 1 ms) was significantly (P < 0.001) increased by NE (34 ± 1 ms) and ACh (50 ± 2 ms). The fully excitable portion (7 ± 1 ms) was also significantly (P < 0.001) increased by NE (17 ± 1 ms) and ACh (43 ± 2 ms). We conclude that both neurotransmitters increase the safety margin of full excitability ahead of the wavefront, demonstrating that parasympathetic and sympathetic activation can facilitate the persistence of this refractory atrial arrhythmia.Key words: atrial flutter, acetylcholine, norepinephrine, excitable gap.

scholarly journals Atrial anti-tachycardia pacing resulting in termination of atrial flutter: intracardiac electrograms providing insight into the mechanism of arrhythmia termination

2019 ◽  
Vol 47 (7) ◽  
pp. 3389-3393
Author(s):  
Shingo Maeda ◽  
Masahiko Goya ◽  
Atsuhiko Yagishita ◽  
Yoshihide Takahashi ◽  
Mihoko Kawabata ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Randomized Study ◽  
Right Atrial ◽  
Dual Chamber Pacemaker ◽  
Af Ablation ◽  
Right Atrial Appendage ◽  
Ablation Study ◽  
The Right ◽  
Insight Into

The “MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure” (MINERVA) multicenter randomized study demonstrated that atrial anti-tachycardia pacing (A-ATP) can effectively decrease the burden of atrial fibrillation (AF) in patients with bradycardia and atrial tachyarrhythmias. We herein describe the unique electrophysiological results of AF ablation in a patient for whom atrial flutter (AFL) was terminated by A-ATP from a Medtronic dual-chamber pacemaker. In this case, the atrial activation sequence indicated that the tachycardia was a right atrial typical flutter and that A-ATP from the right atrial appendage would thus be more likely to terminate the tachycardia. This is a novel case involving documented intracardiac electrograms captured during an AF ablation study in a patient in whom AFL was successfully terminated by A-ATP. These findings provide insight into the mechanisms by which A-ATP can terminate atrial arrhythmias.

Abstract 15570: Direct Evidence of Endo-Epicardial Dissociation of the Atrial Wall in Patients With Longstanding Persistent Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Natasja de Groot ◽  
Lisette vd Does ◽  
Ameeta Yaksh ◽  
Paul Knops ◽  
Pieter Woestijne ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Direct Evidence ◽  
Persistent Atrial Fibrillation ◽  
Right Atrial ◽  
Electrode Arrays ◽  
Atrial Wall ◽  
Ablative Therapies ◽  
Epicardial Layer ◽  
Right Atrial Appendage ◽  
The Right

Introduction: Transition of paroxysmal to longstanding persistent atrial fibrillation (LsPAF) is associated with progressive longitudinal dissociation in conduction and a higher incidence of focal fibrillation waves. The aim of this study was to provide direct evidence that the substrate of LsPAF consists of an electrical double-layer of dissociated waves, and that focal fibrillation waves are caused by endo-epicardial breakthrough. Hypothesis: LsPAF in humans is caused by electrical dissociation of the endo- and epicardial layer. Methods: Intra-operative mapping of the endo- and epicardial right atrial wall was performed in 9 patients with induced (N=4), paroxysmal (N=1), persistent (N=2) or longstanding-persistent AF (N=2). A clamp of two rectangular electrode-arrays (128 electrodes; inter-electrode distance 2mm) was introduced through an incision in the right atrial appendage. Series of 10 seconds of AF were analyzed and the incidence of endo-epicardial dissociation (≥15ms) was determined for all 128 endo-epicardial recording sites. Results: In patients with LsPAF the averaged degree of endo-epicardial dissociation was highest (24.9% vs. 5.9%). Using strict criteria for breakthrough (presence of an opposite wave within 4mm and <15ms before the origin of the focal wave), the far majority (77%) of all focal fibrillation waves could be attributed to endo-epicardial excitation. Conclusions: During LsPAF considerable differences in activation of the right endo- and epicardial wall exist. Endo-epicardial fibrillation waves that are out of phase, may conduct transmurally and create breakthrough waves in the opposite layer. This may explain the high persistence of AF and the low succes rate of ablative therapies in patients with LsPAF.

scholarly journals Transthoracic Right Atrial Cannulation for Total Parenteral Nutrition — Case Report

1981 ◽  
Vol 9 (1) ◽  
pp. 53-57 ◽  
Author(s):  
L. Hayden ◽  
G. Ramsey Stewart ◽  
D. C. Johnson ◽  
M. McD. Fisher
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Right Atrium ◽  
Venous Catheter ◽  
Right Atrial ◽  
X Ray ◽  
Right Thoracotomy ◽  
Right Atrial Appendage ◽  
The Right ◽  
Nutrition Programme

A man with severe peripheral vascular disease and requiring total parenteral nutrition because of short bowel syndrome was referred because a central venous catheter could not be inserted by conventional techniques. A right thoracotomy was performed and a Hickman catheter inserted via the right atrial appendage into the right atrium. This catheter was used for a total of seven months for total parenteral nutrition. For the last two months of this time, the patient was maintained at home on a Home Parenteral Nutrition Programme. After four months of total parenteral nutrition the patient developed recurrent fevers and the catheter was found to have migrated from the right atrium into the pulmonary artery. The catheter was resited under x-ray control and used for a further three months until the recurrence of fever and dyspnoea heralded the onset of septic pulmonary emboli resulting in his death.

scholarly journals A case of restrictive cardiomyopathy complicated by recurrent pulmonary thromboembolism originating at the right atrial appendage

2020 ◽  
Vol 21 (6) ◽  
pp. 220-223
Author(s):  
Hiroaki Yamamoto ◽  
Chieko Itamoto ◽  
Minato Hayashi ◽  
Tsunesuke Kohno ◽  
Yu Matsumura ◽  
...  
Keyword(s):  
Pulmonary Thromboembolism ◽  
Restrictive Cardiomyopathy ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Right Atrial Appendage ◽  
The Right

Pulmonary C-fibers reflexly increase secretion by tracheal submucosal glands in dogs

1985 ◽  
Vol 58 (3) ◽  
pp. 907-910 ◽  
Author(s):  
H. D. Schultz ◽  
A. M. Roberts ◽  
C. Bratcher ◽  
H. M. Coleridge ◽  
J. C. Coleridge ◽  
...  
Keyword(s):  
Gland Secretion ◽  
Right Atrial ◽  
Vagus Nerves ◽  
C Fibers ◽  
Airway Secretion ◽  
Submucosal Glands ◽  
C Fiber ◽  
Anesthetized Dogs ◽  
The Right ◽  
Stimulation Of

Stimulation of bronchial C-fibers evokes a reflex increase in secretion by tracheal submucosal glands, but the influence of pulmonary C-fibers on tracheal gland secretion is uncertain. In anesthetized dogs with open chests, we sprayed powdered tantalum on the exposed mucosa of a segment of the upper trachea to measure the rate of secretion by submucosal glands. Secretions from the gland ducts caused elevations (hillocks) in the tantalum layer. We counted hillocks at 10-s intervals for 60 s before and 60 s after we injected capsaicin (10–20 micrograms/kg) into the right atrium to stimulate pulmonary C-fiber endings. Right atrial injection of capsaicin increased the rate of hillock formation fourfold, but left atrial injection had no significant effect. The response was abolished by cutting the vagus nerves or cooling them to 0 degree C. We conclude that the reflex increase in tracheal submucosal gland secretion evoked by right atrial injection of capsaicin was initiated as capsaicin passed through the pulmonary vascular bed, and hence that pulmonary C-fibers, like bronchial C-fibers, reflexly increase airway secretion.

Expression of Follistatin-Like 3 is not Altered in the Right Atrial Appendage in Patients with Myocardial Infarction

2018 ◽  
Vol 27 ◽  
pp. S317
Author(s):  
M. Morten ◽  
T. Senanayake ◽  
L. Butel-Simões ◽  
N. Mabotuwana ◽  
A. Boyle ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Right Atrial Appendage ◽  
The Right

Right atrial appendectomy reduces the renal response to acute hypervolemia in the rat

1984 ◽  
Vol 247 (3) ◽  
pp. R610-R613 ◽  
Author(s):  
A. T. Veress ◽  
H. Sonnenberg
Keyword(s):  
Atrial Natriuretic Factor ◽  
Control Period ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Blood Flows ◽  
Natriuretic Factor ◽  
Right Atrial Appendage ◽  
The Right ◽  
Experimental Group ◽  
Atrial Natriuretic

We have shown previously that an extract of atrial tissue from rat heart contains a potent natriuretic factor. In this study anesthetized rats were connected to a respirator and the right atrial appendage was either excised, using a loop ligature (experimental group), or the loop was placed around the appendage and then removed (sham-operated group). After equilibration and control urine collection periods an isooncotic Ringers-albumin solution was infused intravenously (25% of estimated blood volume), and renal function was monitored over the next hour. There were no differences between groups in control period arterial or central venous pressures, heart rates, cardiac outputs, renal blood flows, or filtration rates. However, the diuretic and natriuretic responses to infusion in the experimental group were only one half of those in the sham-operated series (vol = 23.4 +/- 6.2 vs. 68.2 +/- 11.0 microliter X min-1 X g kidney wt-1, UNa V = 2,731 +/- 856 vs. 6,504 +/- 962 nmol X min-1 X g kidney wt-1). These differences were not affected by prior bilateral vagotomy. Administration of homologous atrial natriuretic factor or furosemide resulted in identical renal responses in both groups. We conclude therefore that acute hypervolemia is associated with release of atrial natriuretic factor into the bloodstream and that removal of the atrial appendage reduces the amount available for such release.

Sign in / Sign up

Export Citation Format

Share Document