What is the clinical evidence from this study?

Study design: Other. Population: Focal paroxysmal atrial fibrillation (n=21). Intervention: Local high-frequency electrical stimulation to the PVs/SVC. Primary outcome: Induction of atrial premature depolarizations (APDs), atrial tachycardia (AT), and atrial fibrillation (AF).

What does this research mean for the field?

High-frequency electrical stimulation to the pulmonary veins and superior vena cava in dogs induces rapid ectopic beats and atrial fibrillation, indicating that alterations in local autonomic tone likely play a pathophysiologic role in focal paroxysmal atrial fibrillation. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To investigate whether local high-frequency electrical stimulation of the pulmonary veins and superior vena cava triggers focal atrial fibrillation through autonomic nervous system mechanisms.

May 1, 2001Journal of Cardiovascular ElectrophysiologyOpen Access

Focal Atrial Fibrillation: Experimental Evidence for a Pathophysiologic Role of the Autonomic Nervous System

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Key result

High-frequency electrical stimulation to the pulmonary veins and superior vena cava in dogs induced rapid ectopic beats and atrial fibrillation, likely via alterations in local autonomic tone.

Why the study?

Does local high-frequency electrical stimulation to the PVs/SVC induce focal atrial activation and AF/AT in mongrel dogs?

Population

21 mongrel dogs

Design

Preclinical

Authors

PSPatrick SchauerteElectrophysiology BSBenjamin J. ScherlagElectrophysiology EPEugene PattersonUniversity of Oklahoma Medical Center

Discussion

Member takes

Implication

Supports autonomic modulation of PV/SVC triggers in experimental AF; leaves open translation to human ablation strategies.

Key Points

To investigate whether local high-frequency electrical stimulation of the pulmonary veins and superior vena cava triggers focal atrial fibrillation through autonomic nervous system mechanisms.
Delivered high-frequency electrical stimulation (200 Hz, 0.1 msec duration) to the pulmonary veins and superior vena cava during atrial refractoriness in 21 mongrel dogs.
Assessed electrophysiological changes and arrhythmia inducibility before and after pharmacological autonomic blockade using beta-blockers and atropine.
Performed in vitro microelectrode recordings to evaluate cellular action potential duration and early afterdepolarizations in response to local electrical stimulation.
High-frequency stimulation induced premature depolarizations and atrial tachycardia or fibrillation in 12 of 12 dogs in the superior vena cava and 8 of 9 dogs in the left superior pulmonary vein, triggering arrhythmias at 15±9 V in pulmonary veins and 26±6 V in the superior vena cava (both P < 0.01).
In vitro stimulation triggered heterogeneous cellular effects, shortening action potentials in some cells from 89±35 msec to 60±22 msec (P < 0.001; n = 7) while prolonging action potentials and producing early afterdepolarizations in others.
Arrhythmia induction was blunted or prevented by beta-receptor blockade, and action potential shortening was abolished by atropine.

Structured PICO

Does local high-frequency electrical stimulation to the PVs/SVC induce focal atrial activation and AF/AT in mongrel dogs?

Population

21 mongrel dogs

Intervention

Local high-frequency electrical stimulation (200 Hz, impulse duration 0.1 msec) to the pulmonary veins (PVs) and superior vena cava (SVC) during atrial refractoriness

Outcome

Induction of atrial premature depolarizations (APDs), atrial tachycardia (AT), and atrial fibrillation (AF)surrogate

High-frequency electrical stimulation of the PVs and SVC in dogs induces rapid ectopic beats and AF, suggesting a pathophysiologic role of local autonomic tone in focal paroxysmal AF.

Limitations

Further research is needed to prove absolutely that the observed effects of high-frequency electrical stimulation were caused by autonomic nerve stimulation.

Cite This Study

Schauerte et al. (2001) studied Focal paroxysmal atrial fibrillation (n=21). Local high-frequency electrical stimulation to the PVs/SVC was evaluated on Induction of atrial premature depolarizations (APDs), atrial tachycardia (AT), and atrial fibrillation (AF). High-frequency electrical stimulation to the pulmonary veins and superior vena cava in dogs induced rapid ectopic beats and atrial fibrillation, likely via alterations in local autonomic tone.

synapsesocial.com/papers/6a158ef179ff98d0de4ecf70 https://doi.org/10.1046/j.1540-8167.2001.00592.x

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

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Focal Atrial Fibrillation: Experimental Evidence for a Pathophysiologic Role of the Autonomic Nervous System

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Focal Atrial Fibrillation: Experimental Evidence for a Pathophysiologic Role of the Autonomic Nervous System

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider