Anatomical distribution of ectopy-triggering plexuses in patients with atrial fibrillation
MY Kim, BC Sandler, MB Sikkel… - Circulation …, 2020 - Am Heart Assoc
Circulation: Arrhythmia and Electrophysiology, 2020•Am Heart Assoc
One of the key structures previously targeted for AF treatment are ganglionated plexuses
(GPs), which are part of the intrinsic cardiac autonomic nervous system. GPs contain dense
clusters of nerves that are abundant in the atrial epicardium. There are common clusters of
GP in the human heart, mostly around the pulmonary vein (PV) antrum, interatrial septum,
and inferior portion of the posterior left atrial wall. 1 Specific localization of the epicardial GP
is achieved from the endocardium using a mapping catheter to deliver high frequency …
(GPs), which are part of the intrinsic cardiac autonomic nervous system. GPs contain dense
clusters of nerves that are abundant in the atrial epicardium. There are common clusters of
GP in the human heart, mostly around the pulmonary vein (PV) antrum, interatrial septum,
and inferior portion of the posterior left atrial wall. 1 Specific localization of the epicardial GP
is achieved from the endocardium using a mapping catheter to deliver high frequency …
One of the key structures previously targeted for AF treatment are ganglionated plexuses (GPs), which are part of the intrinsic cardiac autonomic nervous system. GPs contain dense clusters of nerves that are abundant in the atrial epicardium. There are common clusters of GP in the human heart, mostly around the pulmonary vein (PV) antrum, interatrial septum, and inferior portion of the posterior left atrial wall. 1 Specific localization of the epicardial GP is achieved from the endocardium using a mapping catheter to deliver high frequency stimulation (HFS). There are 2 different functional types of GP previously identified using different HFS techniques: atrioventricular dissociating GP (AVD-GP), which causes significant bradycardia or asystole during AF and atrial (PV or non-PV) ectopy-triggering GP (ET-GP) during sinus rhythm. 2 We previously showed that AVD-GPs have anatomically discrete distribution in the left atrium of patients with AF; inferolateral portion of the posterior wall, interatrial septum, and the anterior portion of the right superior PV antrum. 3 However, selective mapping and ablation of AVD-GP has limited role in AF. 4 The anatomic distribution of ET-GPs and their role in AF is yet to be determined. Our aim was to map ET-GP in the left atrium of patients with AF and compare their anatomic distribution to AVD-GP.
Am Heart Assoc
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