Role of the posterior papillary muscle and Purkinje potentials in the mechanism of ventricular fibrillation in open chest dogs and swine

Effects of catheter ablation

Hui Nam Pak, Young Hoon Kim, Hong Euy Lim, Chung Chuan Chou, Yasushi Miyauchi, Yong Hu Fang, Kyung Sun, Chun Hwang, Peng Sheng Chen

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Effects of Catheter Ablation. Background: Papillary muscle (PM) ablation may terminate ventricular fibrillation (VF) in rabbit hearts. Whether or not PM ablation prevents ventricular fibrillation (VF) induction in large animals is unknown. Methods: We performed noncontact endocardial mapping and/or high-density epicardial mapping during VF in 12 dogs and 16 swine and tested the effects of posterior PM (PPM) ablation on VF inducibility. Results: During VF in progressive global ischemia (3 swine and 2 dogs), the highest dominant frequency (DF) was near PPM. The majority of the reentrant wavefronts during a propranolol infusion (swine) were anchored to the PPM. Purkinje potentials onset were recorded on the PPM both during sinus rhythm and during VF. Radiofrequency (RF) ablation of the endocardium on the PPM with a linear extension of the ablation line from the PPM to the mitral valve annulus and then the left ventricular apex in 7 dogs reduced the VF inducibility from 100% at baseline to 22% after ablation (P < 0.0001). RF applications to the anterolateral wall of dogs (n = 3) did not prevent VF induction. The application of RF energy near the PPM frequently initiated VF in swine (n = 7), preventing subsequent testing of VF inducibility. Conclusion: In dogs and swine, the highest DF and majority of reentrant wavefronts during VF with acute global ischemia or during a propranolol infusion were located on the PPM. RF ablation targeted at the PPM reduced the inducibility of VF in normal dogs. However, the same ablation provoked incessant VF in swine, preventing subsequent testing of VF inducibility.

Original languageEnglish
Pages (from-to)777-783
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume17
Issue number7
DOIs
Publication statusPublished - 2006 Jul 1

Fingerprint

Catheter Ablation
Papillary Muscles
Ventricular Fibrillation
Swine
Thorax
Dogs
Propranolol
Ischemia
Epicardial Mapping
Endocardium
Mitral Valve

Keywords

  • Arrhythmia
  • Catheter ablation
  • Fibrillation
  • Mapping
  • Papillary muscle
  • Purkinje potentials
  • Ventricle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Role of the posterior papillary muscle and Purkinje potentials in the mechanism of ventricular fibrillation in open chest dogs and swine : Effects of catheter ablation. / Pak, Hui Nam; Kim, Young Hoon; Lim, Hong Euy; Chou, Chung Chuan; Miyauchi, Yasushi; Fang, Yong Hu; Sun, Kyung; Hwang, Chun; Chen, Peng Sheng.

In: Journal of Cardiovascular Electrophysiology, Vol. 17, No. 7, 01.07.2006, p. 777-783.

Research output: Contribution to journalArticle

Pak, Hui Nam ; Kim, Young Hoon ; Lim, Hong Euy ; Chou, Chung Chuan ; Miyauchi, Yasushi ; Fang, Yong Hu ; Sun, Kyung ; Hwang, Chun ; Chen, Peng Sheng. / Role of the posterior papillary muscle and Purkinje potentials in the mechanism of ventricular fibrillation in open chest dogs and swine : Effects of catheter ablation. In: Journal of Cardiovascular Electrophysiology. 2006 ; Vol. 17, No. 7. pp. 777-783.
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abstract = "Effects of Catheter Ablation. Background: Papillary muscle (PM) ablation may terminate ventricular fibrillation (VF) in rabbit hearts. Whether or not PM ablation prevents ventricular fibrillation (VF) induction in large animals is unknown. Methods: We performed noncontact endocardial mapping and/or high-density epicardial mapping during VF in 12 dogs and 16 swine and tested the effects of posterior PM (PPM) ablation on VF inducibility. Results: During VF in progressive global ischemia (3 swine and 2 dogs), the highest dominant frequency (DF) was near PPM. The majority of the reentrant wavefronts during a propranolol infusion (swine) were anchored to the PPM. Purkinje potentials onset were recorded on the PPM both during sinus rhythm and during VF. Radiofrequency (RF) ablation of the endocardium on the PPM with a linear extension of the ablation line from the PPM to the mitral valve annulus and then the left ventricular apex in 7 dogs reduced the VF inducibility from 100{\%} at baseline to 22{\%} after ablation (P < 0.0001). RF applications to the anterolateral wall of dogs (n = 3) did not prevent VF induction. The application of RF energy near the PPM frequently initiated VF in swine (n = 7), preventing subsequent testing of VF inducibility. Conclusion: In dogs and swine, the highest DF and majority of reentrant wavefronts during VF with acute global ischemia or during a propranolol infusion were located on the PPM. RF ablation targeted at the PPM reduced the inducibility of VF in normal dogs. However, the same ablation provoked incessant VF in swine, preventing subsequent testing of VF inducibility.",
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T1 - Role of the posterior papillary muscle and Purkinje potentials in the mechanism of ventricular fibrillation in open chest dogs and swine

T2 - Effects of catheter ablation

AU - Pak, Hui Nam

AU - Kim, Young Hoon

AU - Lim, Hong Euy

AU - Chou, Chung Chuan

AU - Miyauchi, Yasushi

AU - Fang, Yong Hu

AU - Sun, Kyung

AU - Hwang, Chun

AU - Chen, Peng Sheng

PY - 2006/7/1

Y1 - 2006/7/1

N2 - Effects of Catheter Ablation. Background: Papillary muscle (PM) ablation may terminate ventricular fibrillation (VF) in rabbit hearts. Whether or not PM ablation prevents ventricular fibrillation (VF) induction in large animals is unknown. Methods: We performed noncontact endocardial mapping and/or high-density epicardial mapping during VF in 12 dogs and 16 swine and tested the effects of posterior PM (PPM) ablation on VF inducibility. Results: During VF in progressive global ischemia (3 swine and 2 dogs), the highest dominant frequency (DF) was near PPM. The majority of the reentrant wavefronts during a propranolol infusion (swine) were anchored to the PPM. Purkinje potentials onset were recorded on the PPM both during sinus rhythm and during VF. Radiofrequency (RF) ablation of the endocardium on the PPM with a linear extension of the ablation line from the PPM to the mitral valve annulus and then the left ventricular apex in 7 dogs reduced the VF inducibility from 100% at baseline to 22% after ablation (P < 0.0001). RF applications to the anterolateral wall of dogs (n = 3) did not prevent VF induction. The application of RF energy near the PPM frequently initiated VF in swine (n = 7), preventing subsequent testing of VF inducibility. Conclusion: In dogs and swine, the highest DF and majority of reentrant wavefronts during VF with acute global ischemia or during a propranolol infusion were located on the PPM. RF ablation targeted at the PPM reduced the inducibility of VF in normal dogs. However, the same ablation provoked incessant VF in swine, preventing subsequent testing of VF inducibility.

AB - Effects of Catheter Ablation. Background: Papillary muscle (PM) ablation may terminate ventricular fibrillation (VF) in rabbit hearts. Whether or not PM ablation prevents ventricular fibrillation (VF) induction in large animals is unknown. Methods: We performed noncontact endocardial mapping and/or high-density epicardial mapping during VF in 12 dogs and 16 swine and tested the effects of posterior PM (PPM) ablation on VF inducibility. Results: During VF in progressive global ischemia (3 swine and 2 dogs), the highest dominant frequency (DF) was near PPM. The majority of the reentrant wavefronts during a propranolol infusion (swine) were anchored to the PPM. Purkinje potentials onset were recorded on the PPM both during sinus rhythm and during VF. Radiofrequency (RF) ablation of the endocardium on the PPM with a linear extension of the ablation line from the PPM to the mitral valve annulus and then the left ventricular apex in 7 dogs reduced the VF inducibility from 100% at baseline to 22% after ablation (P < 0.0001). RF applications to the anterolateral wall of dogs (n = 3) did not prevent VF induction. The application of RF energy near the PPM frequently initiated VF in swine (n = 7), preventing subsequent testing of VF inducibility. Conclusion: In dogs and swine, the highest DF and majority of reentrant wavefronts during VF with acute global ischemia or during a propranolol infusion were located on the PPM. RF ablation targeted at the PPM reduced the inducibility of VF in normal dogs. However, the same ablation provoked incessant VF in swine, preventing subsequent testing of VF inducibility.

KW - Arrhythmia

KW - Catheter ablation

KW - Fibrillation

KW - Mapping

KW - Papillary muscle

KW - Purkinje potentials

KW - Ventricle

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