Atrioventricular nodal fast pathway modification: mechanism for lack of ventricular rate slowing in atrial fibrillation

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• 作者：Zhang ; Youhua ; Bharati ; Saroja ; Sulayman ; Rabi ; Mowrey ; Kent A. ; Tchou ; Patrick J. ; Mazgalev ; Todor N.
• 关键词：Atrial fibrillation ; Ablation ; Arrhythmia (mechanisms) ; AV-node ; Conduction system ; Supraventricular arrhythmia ; Rabbit ; Dual pathway electrophysiology
• 刊名：Cardiovascular Research
• 出版年：2004
• 出版时间：January 1, 2004
• 年：2004
• 卷：61
• 期：1
• 页码：45-55
• 全文大小：1.98 M

文摘

Objectives: Atrioventricular node (AVN) modification is one of the alternatives for ventricular rate control in patients with drug refractory atrial fibrillation (AF). However, the underlying mechanisms, and in particular the role of the dual pathway electrophysiology is not clear. By using a novel index, His electrogram (HE) alternans, we have previously demonstrated in rabbits that both the slow (SP) and the fast pathways (FP) are involved in AVN conduction during AF. This electrophysiological–morphological study was designed to address the role of selective FP ablation on AVN conduction during AF. Methods and Results: In 12 rabbit AVN preparations dual pathway conduction was confirmed by HE alternans during A1A2 pacing protocol, as well as during AF. On average 48 % of the conducted beats during AF utilized the FP. Selective FP ablation (n