Key result
CFAE sites in canine AF exhibit ~81% more interstitial tissue and GPs than non-CFAE sites.
Why the study?
Does the structural and neural substrate differ between CFAE and non-CFAE sites in a canine model of atrial fibrillation?
Does the structural and neural substrate differ between CFAE and non-CFAE sites in a canine model of atrial fibrillation?
Absolute Event Rate: 61.7% vs 34.1%
p-value: p=<0.01
CFAE sites in a canine AF model are characterized by disorganized myocardium with increased interstitial tissue and abundant ganglionated plexi, providing a structural and neural basis for these electrograms.
Supports structural-neural basis for CFAE in canine AF; leaves open translation to human ablation outcomes.
BACKGROUND: Ablation of complex fractionated atrial electrograms (CFAE) is an important adjunctive therapy in atrial fibrillation (AF). The present study was to elucidate the substrate underlying CFAE. METHODS: Nine adult mongrel dogs were involved in the present study. AF was induced through rapid atrial pacing with vagosympathetic nerve stimulation. CFAE was recorded during AF. Ablation was performed at CFAE sites. Based on the location of the ablation scar, the atrial specimens were divided into CFAE and non-CFAE sites. Serial sections of the atrium were stained respectively with hematoxylin-eosin (HE) and the general neural marker protein gene product 9.5 (PGP9.5). We compared the characteristics of the myocardium and the ganglionated plexus (GPs) distribution between the CFAE and non-CFAE sites. RESULTS: The myocardium of non-CFAE sites was well-organized with little intercellular substance. However, the myocardium in the CFAE site was disorganized with more interstitial tissue ((61.7 ± 24.3)% vs. (34.1 ± 9.2)%, P < 0.01). GPs in the CFAE site were more abundant than in non-CFAE sites ((34.45 ± 37.46) bundles/cm(2) vs. (6.73 ± 8.22) bundles/cm(2), P < 0.01). CONCLUSION: The heterogeneity of the myocardium and GPs distribution may account for the substrate of CFAE and serve as a potential target of ablation.
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De-jun et al. (2012) studied Atrial fibrillation (n=9). CFAE sites vs. non-CFAE sites was evaluated on Interstitial tissue percentage (p=<0.01). CFAE sites in a canine model of atrial fibrillation exhibited significantly more interstitial tissue (61.7% vs 34.1%, P<0.01) and more abundant ganglionated plexuses than non-CFAE sites.
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