Impaired Longitudinal Conduction in Crista Terminalis is Necessary for Sustenance of Experimental Atrial Flutter

Sustained atrial flutter (AFL) can be induced by creating a lesion between the vena cava in dogs. In previous studies on this model, the crista terminalis (CT) was often injured, and thus, role of CT in sustained reentry was not well understood. We hypothesized that impaired longitudinal conduction...

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Published in:Pacing and clinical electrophysiology 2003-10, Vol.26 (10), p.2008-2015
Main Authors: KOBAYASHI, TAKAO, KIMURA, MASAOMI, OWADA, SHINGEN, ASHIKAGA, KEIICHI, SASAKI, SHINGO, HIGUMA, TAKUMI, IWASA, ATSUSHI, KAMATA, YOSHIMASA, MOTOMURA, SHIGERU, OKUMURA, KEN
Format: Article
Language:English
Subjects:
Analysis of Variance
Animals
atrial flutter
Atrial Flutter - physiopathology
Catheter Ablation - adverse effects
crista terminalis
Dogs
Electrocardiography
Heart Conduction System - physiopathology
reentry
slow conduction
Tricuspid Valve - injuries
Tricuspid Valve - physiopathology
Venae Cavae - injuries
Venae Cavae - physiopathology
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Summary:Sustained atrial flutter (AFL) can be induced by creating a lesion between the vena cava in dogs. In previous studies on this model, the crista terminalis (CT) was often injured, and thus, role of CT in sustained reentry was not well understood. We hypothesized that impaired longitudinal conduction in CT is necessary for sustained AFL. In 16 anesthetized, open‐chest dogs, linear radiofrequency ablation of the intercaval region was performed without interrupting CT. Intra‐atrial conduction times (IAT) along CT were measured using a plaque electrode (25 × 35 mm) containing 30 bipolar electrodes before and after additional ablation of CT (group A, n = 10) or the pectinate muscle (PM) region (group B, n = 6). In group A, IAT along CT was 27 ± 5 ms at baseline and was increased to 43 ± 3 ms after ablation of CT (P < 0.001). In group B, IAT along CT was 28 ± 4 ms at baseline and 27 ± 3 ms after ablation of PM (P = NS). Sustained AFL lasting >20 minutes was induced in 10/10 dogs in group A only after additional ablation of CT, and in 0/6 dogs in group B (P < 0.001). The cycle lengths of AFL after ablation of the intercaval region and additional ablation of CT were 119 ± 14 and 140 ± 14 ms, respectively (P < 0.01). There was a significant positive correlation between the cycle length of AFL and IAT along CT (r2= 0.63, P < 0.001). These results indicate that longitudinal conduction property in CT and not in PM strongly affects sustenance of AFL in this model. (PACE 2003; 26:2008–2015)
ISSN:0147-8389
1540-8159
DOI:10.1046/j.1460-9592.2003.00310.x