Basic Research
Re-entry hypothesis testing within ligament of Marshall as a mechanisma for sustaining atrial fibrillation in dogs
Chunshan Lu, Dongping Fang, Aiguo Zhang, Peng Hao, Dongfang He, Lin Zhao, Yunpeng Chi, Kejuan Ma, Yu Zhang, Qiaoyuan Li, Mankun Xin, Cancan Lin, Chengjun Guo, Xingpeng Liu
Published 2018-09-25
Cite as Chin J Thorac Cardiovasc Surg, 2018, 34(9): 548-551. DOI: 10.3760/cma.j.issn.1001-4497.2018.09.009
Abstract
ObjectiveTo explore the mechanisms of ligament of Marshall(LOM) initiat and sustain atrial fibrillation(AF).
MethodsThe electrophysiologic properties of canine LOM were investigated using multipolar catheter mapping(normal canines, n=4, group A; AF canines, n=5, group B). The programmed stimulation were performed in the LOM, PV-left atrium(LA)junction and LA, respectively. Activations maps of LOM were analyzed from episodes of spontaneous onset of AF and initiation of induced AF by a single extrastimulus. The effectives refractory period of each part was compared and statistically analyzed among three parts in each group and between the two groups. LOM were cutted with surgical incision technology. The inducing rate of AF and the mapping rate of double potential and fragmented electrocardiogram were compared and statistically analyzed pro and post isolation of LOM.
ResultsThe incidence of abnormal potential of LOM in the two groups was significantly different(P<0.01), re-entry cycle(group A 25% vs. B group 80%), tachycardia(group A 25% vs. B 100%), double potential(group A 25% vs. group B 80%), fragmentation potential(group A 25% vs. group 80%). There was a significant difference in the rate of LOM tachycardia induction before and after LOM intervention in group B(P<0.05, before 100% vs. after 20%).
ConclusionThere are two possible mechanisms of LOM involved in the occurrence and maintenance of AF: one is that LOM induces AF through spontaneous excitation, the other is that LOM participates in the reentry of left atrium and pulmonary vein in the form of bypass to induce and maintain AF.
Key words:
Atrial fibrillation; Ligament of marshall; Re-entry; Mapping; Left atrium
Contributor Information
Chunshan Lu
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
Dongping Fang
Aiguo Zhang
Peng Hao
Dongfang He
Lin Zhao
Yunpeng Chi
Kejuan Ma
Yu Zhang
Qiaoyuan Li
Mankun Xin
Cancan Lin
Chengjun Guo
Xingpeng Liu
