CFAEs. CFAEs CFAEs CFAEs

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1 CFAEs 22 CFAEs CFAEs CFAEs CFAEs CFAEs CFAEs DOI /zgxzqb http / /www. cnki. net /kcms /detail / R html R R R A The frequency and distribution of complex fractionated atrial electrograms in a canine model of atrial fibrillation induced by local electrical stimulation. LIU Peng 1 GUO Ji-hong 2 ZHANG Zhen 1 LI Jiao 1 LIU Hou-guang 1 ZHANG Hai-cheng 2. 1 Department of Cardiovascular Medicine China Meitan General Hospital Beijing China 2 Department of Cardiology People's Hospital Peking University Beijing China Corresponding author LIU Peng liupeng1037@ sohu. com Abstract Objective To investigate the frequency and distribution of complex fractionated atrial electrograms CFAEs in a canine model of atrial fibrillation AF induced by local electrical stimulation at different sites in the atria and 4 pulmonary veins PVs. Methods In 22 mongrel dogs the cervical vagal trunks were isolated bilaterally and decentralized. Local burst stimulation S 1 S 1 = 80 ms impulse duration 0. 5 ms and programmed stimulation were performed to right appendage RAA left appendage LAA and different sites of 4 PVs. AF inducibility and CFAEs were determined at each site in the baseline state and during bilateral cervical vagal nerve stimulation VNS Hz impulse duration 0. 5 ms stimulation voltage 5-8 V. Results The sites of local electrical stimulation initiating AF were not at the same location as those of the CFAEs. CFAEs were observed more frequently at RAA LAA and the proximal portions of 4 PVs during AF. The prevalence of CFAEs was higher during VNS. Conclusion It is more common to map CFAEs at several sites of PVs during AF. VNS increases the frequency of CFAEs. Chinese Journal of Cardiac Pacing and Electrophysiology Key words Cardiology Atrial fibrillation Pulmonary vein Complex fractionated atrial electrograms Vagal nerve Electrophysiology 1 CFAEs CFAEs CFAEs liupeng1037@ sohu. com 2 3 CFAEs 29% CFAEs

2 437 CFAEs RAA LAA Burst S 1 S ~ 23 kg 3 ms ms 5% 20 mg /kg 3 30 s 2 5% mg kg - 1 h - 1 Hz 0. 5 ms 5 ~ 8 V KTH-3 > 2 s 4 ~ 6 L /min Burst 10 ml /kg 0 ~ 2 Kpa 5 > 500 / ~ CFAEs 10 s 6 CFAEs CFAEs ms ms < 50 ms min % 50 ms F RV 5F 3 2 mm 5 mm Bard 1 2 RAA LAA LSPV LIPV RSPV RIPV 14 Burst 3 1 ~ 2 32 GY ~ 2 2 ~ CFAEs 3 ~ 4 Burst 30 ~ 500 Hz CFAEs RAA LAA PSA Biotronik CFAEs 0. 5 ms 10 CFAEs 1 ~ 20 / LSPV LSPV LSPVp DF-5A 6 LSPVp CFAEs 2 S 1 S ms S 1 S 2 = 200 ms LSPV 7-10 ms RAA LAA 0. 5 ms 2 CFAEs 1 CFAEs CFAEs RAA LAA LSPVp LSPVm LSPVd LIPVp LIPVm LIPVd RSPVp RSPVm RSPVd RIPVp RIPVm RIPVd p = m = d =

3 LIPVp CFAEs RAA 2 RAA CFAEs LSPVp LSPVm LSPVd LIPVd A P % CFAEs 1 CFAEs 91% Oral 2 CFAEs CFAEs Nademanee CFAEs % CFAEs CFAEs 57% 3 44% 2 3 CFAEs 1 3 CFAEs CFAEs Nademanee 6 CFAEs CFAEs CFAEs

4 439 3 LIPVp S 1 S /120 ms LSPVp LIPVp RIPVp RIPVm CFAEs CFAEs CFAEs CFAEs CFAEs 8 CFAEs 9 GP CFAEs CFAEs 16 GP 13 CFAEs GP CFAES CFAEs 14 CFAEs 6 1 CFAEs 2

5 Scherlag BJ Yamanashi W Patel U et al. Autonomically induced conversion of pulmonary vein focal firing into atrial fibrillation J. J Am Coll Cardiol Liu P Guo JH Zhang HC et al. Vagal effects on the occurrence of 1 Crawford TC Wimmer A Dey S et al. Mechanism of recurrence after radiofrequency catheter ablation of atrial fibrillation guided by focal atrial fibrillation originating from pulmonary veins J. Circulation Journal complex fractionated atrial electrograms J. J Interv Card Electrophysiol J Oral H Chugh A Good E et al. Radiofrequency catheter ablation 317 of chronic atrial fibrillation guided by complex electrograms J. Circulation Gao CH Wang F Jiang R et al. A region-specific quantitative profile of autonomic innervation of the canine left atrium and pulmonary 3 Verma A Mantovan R Macle L et al. Substrate and trigger ablation veins J. Auton Neurosci for reduction of atrial fibrillation STAR AF a randomized multicentre international trial J. Euro Heart J Lin J Scherlag BJ Zhou J et a1. Autonomic mechanism to explain complex fractionated atrial electrograms CFAE J. J Cardiovasc 4. Electrophysiol J Pappone C Santinelli V Manguso F et al. Pulmonary vein denervation 5 Sharifov OF Zaitser AV Rosenshtraukh LV et al. Spatial distribution and frequency dependence of arrhythogenic vagal effects in enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation J. Circulation canine atria J. J Cardiovasc Electrophysiol Nademanee K McKenzie J Kosar E et al. A new approach for catheter ablation of atrial fibrillation mapping of the electrophysiologic substrate J. J Am Coll Cardiol Nademanee K Schwab M Porath J et al. How to perform electrogram-guided atrial fibrillation ablation J. Heart Rhythm Armour JA Murphy DA Yuan BX et al. Gross and microscopic a- natomy of the human intrinsic cardiac nervous system J. Anat Rec Oliveira M da Silva MN Geraldes V et al. Acute vagal modulation of electrophysiology of the atrial and pulmonary veins increases vulnerability to atrial fibrillation J. Exp Physiol Pokushalov E Romanov A Artyomenko S et al. Ganglionated plexi ablation directed by high-frequency stimulation and complex fractionated atrial electrograms for paroxysmal atrial fibrillation J. Pacing Clin Electrophysiol Serelaxin RELAX-AHF Serelaxin relaxin-2 RELAX-AHF serelaxin RELAX-AHF h serelaxin 30 μ kg - 1 d h BNP N-terminalpro-BNP - > 125 mmhg VAS AUC Visual Analogue Scale 5 24 h Likart Scale serelaxin n = 581 n = 580 serelaxin VAS AUC 448 mm h 95% Cl 120 ~ 775 P = Likart Scale % serelaxin % P = Kaplan-Meier estimate 13. 0% serelaxin % hazard ratio ~ P = SD serelaxin P = serelaxin serelaxin 42 HR % Cl ~ P = Serelaxin serelaxin 180 Teerlink JR et al. Lancet