ISSN 2149-2263 | E-ISSN 2149-2271
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Cervical vagosympathetic and mediastinal nerves activation effects on atrial arrhythmia formation [Anatol J Cardiol]
Anatol J Cardiol. 2007; 7(Suppl 1): 34-36

Cervical vagosympathetic and mediastinal nerves activation effects on atrial arrhythmia formation

Réginald Nadeau1, René Cardinal2, J. Andrew Armour2, Teresa Kus2, Louis-Philippe Richer2, Michel Vermeulen2, Yalin Yin2, Pierre Pagé2
13Department of Medicine, Université de Montréal, Montréal, Québec, Canada
2Research Centre, Hospital du Sacré-Coeur de Montreal, Montreal University, Montreal, Quebec, Canada

In anesthetized dogs both epi-and endocardial atrial activation maps and corresponding isointegral repolarization maps were cre ated before and during right or left mediastinal nerve (RMN and LMN) and cervical vagus nerve (CVN) stimulation. Right mediastinal nerve stimulation typically caused sinus slowing, atrial tachycardia (AT), followed by atrial fibrillation (AF). Activation maps during AT showed epicardial breakthroughs from the right atrial free wall or Bachmann’s bundle. Left mediastinal nerve stimulation (LMN) rarely caused sinus slowing and ATs originated mostly from Bachmann’s bundle or from the pulmonary vein ostial region. Atrial repolarization changes induced by neural stimulation were measured by integrating the area subtended by 161 epicardial unipolar electrograms. Atrial tachycardia epicardial breakthrough sites were closely associated with the border zone where repolarization changes occurred. Both AT and AF were abolished by I.V. atropine, as were sinus bradycardia and atrial repolarization effects of nerve stimulation. Shortening of latency of onset and duration of AT by I.V. timolol suggest concurrent activation of adrenergic efferent neurons. In conclusion, juxta-cardiac mediastinal nerve stimulation caninduce atrial fibrillation from multiple, discrete right and left atrial sites, which correspond to localized repolarization changes. Secondly, sinus bradycardia is not a necessary index of parasympathetic neurally induced atrial fibrillation.

Keywords: Atrial tachyarrhythmias, parasympathetic efferent neuron, atrial mapping, intrinsic cardiac nervous system, vagally mediated atrial fibrillation

Réginald Nadeau, René Cardinal, J. Andrew Armour, Teresa Kus, Louis-Philippe Richer, Michel Vermeulen, Yalin Yin, Pierre Pagé. Cervical vagosympathetic and mediastinal nerves activation effects on atrial arrhythmia formation. Anatol J Cardiol. 2007; 7(Suppl 1): 34-36
Manuscript Language: English


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