Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
J Cardiovasc Electrophysiol. 2010 Dec;21(12):1392-9. doi: 10.1111/j.1540-8167.2010.01787.x.
the mechanism underlying spontaneous rapid superior vena cava (SVC) firing that initiates atrial fibrillation (AF) remains poorly understood. We investigated the role of the SVC-aorta-ganglionated plexus (SVC-Ao-GP) in AF initiated by rapid firing from the SVC.
in 42 dogs, a circular catheter was positioned above the SVC-atrial junction. Multielectrode catheters were sutured on atria, atrial appendages and pulmonary veins. The effective refractory period (ERP) and window of vulnerability (WOV) for AF were measured at all sites in the baseline state, during cervical vagosympathetic trunk stimulation and during SVC-Ao-GP stimulation, before and after SVC-Ao-GP ablation. AF inducibility was also assessed by delivering high-frequency stimulation (HFS) within myocardial refractory period to the SVC before and after SVC-Ao-GP ablation. HFS applied to the SVC-Ao-GP slowed the sinus rate and/or atrioventricular conduction. HFS of the SVC-Ao-GP induced more significant shortening of ERP and a greater increase in WOV at the SVC than other sites. Ablation of the SVC-Ao-GP significantly increased the baseline ERP and decreased the baseline WOV only at the SVC. AF induced at the SVC by HFS during refractoriness was eliminated by ablation of the SVC-Ao-GP but was not altered by ablation of the 4 major atrial GP. Direct injection of acetylcholine into the SVC-Ao-GP initiated rapid firing from the SVC in every case.
the SVC-Ao-GP preferentially modulates the electrophysiological function of the SVC sleeves and may contribute to rapid firing from the SVC.
引发心房颤动（AF）的自发性快速上腔静脉（SVC）触发的机制仍知之甚少。我们研究了 SVC-主动脉-神经节丛（SVC-Ao-GP）在 SVC 快速放电引发 AF 中的作用。
在 42 只狗中，将圆形导管置于 SVC-心房交界处上方。将多电极导管缝合在心房、心房附件和肺静脉上。在基线状态、颈迷走神经干刺激期间和 SVC-Ao-GP 刺激期间测量所有部位的有效不应期（ERP）和 AF 易损窗口（WOV），在 SVC-Ao-GP 消融前后。在 SVC-Ao-GP 消融前后，通过在心肌不应期内对 SVC 施加高频刺激（HFS）也评估了 AF 的可诱导性。应用于 SVC-Ao-GP 的 HFS 可减慢窦性心率和/或房室传导。与其他部位相比，HFS 对 SVC-Ao-GP 的刺激可显著缩短 ERP 并增加 WOV。SVC-Ao-GP 的消融显著增加了 SVC 的基础 ERP，同时仅降低了 SVC 的基础 WOV。HFS 在不应期内对 SVC 诱发的 AF 通过 SVC-Ao-GP 的消融而消除，但通过消融 4 个主要的心房 GP 并未改变。乙酰胆碱直接注入 SVC-Ao-GP 可在每种情况下引发 SVC 的快速放电。
SVC-Ao-GP 优先调节 SVC 套管的电生理功能，可能有助于 SVC 的快速放电。
