Both Purkinje cells and left ventricular posteroseptal reentry contribute to the maintenance of ventricular fibrillation in open-chest dogs and swine - effects of catheter ablation and the ventricular cut-and-sew operation

huinam pak, Gwang Kim, Hong Euy Lim, Yong Hu Fang, Jong Choi, Jin Seok Kim, Chun Hwang, Young Hoon Kim

Research output: Contribution to journalArticle

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Abstract

Background Radio frequency catheter ablation (RFCA) targeting the left ventricular postero septum (LVPS) and posterior papillary muscle (PPM) terminates or prevents ventricular fibrillation (VF) in rabbit and dog hearts. However, whether the mechanism of VF maintenance is reentry or focal Purkinje firing is unclear. Methods and Results In the present study the effects of RFCA (endocardial ablation of PPM+LVPS in 7 dogs and 7 swine), left ventricular anterolateral wall ablation (LVAL in 7 dogs), and the cut-and-sew operation (CSO: along the left ventricular posterior wall (LVPW) beside PPM in 7 swine) on VF inducibility were compared. (1) VF inducibility was decreased from 100±0% to 21.9±31.2% (p<0.0001) by PPM+LVPS endocardial ablation, but not by LVAL ablation in dogs. (2) LVPW CSO reduced VF inducibility (100±0% to 43.6±9.5%, p<0.0001) in swine. (3) In contrast to the canine Purkinje network, which is mostly localized to the subendocardium, the swine Purkinje network extends to the subepicardial layer with a higher density (p<0.001). Conclusion Both PPM+LVPS ablation (Purkinje destruction) in dogs and LVPW CSO (blocking reentry) in swine reduce VF inducibility, suggesting that in both species focal firing from the Purkinje network and reentry around the PPM contributes to the maintenance of VF. (Circ J 2008; 72: 1185-1192).

Original languageEnglish
Pages (from-to)1185-1192
Number of pages8
JournalCirculation Journal
Volume72
Issue number7
DOIs
Publication statusPublished - 2008 Jul 15

Fingerprint

Catheter Ablation
Purkinje Cells
Ventricular Fibrillation
Papillary Muscles
Swine
Thorax
Maintenance
Ventricular Septum
Dogs
Radio
Canidae
Rabbits

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{9e36c6cec3854322b279d91f8ffa0b3b,
title = "Both Purkinje cells and left ventricular posteroseptal reentry contribute to the maintenance of ventricular fibrillation in open-chest dogs and swine - effects of catheter ablation and the ventricular cut-and-sew operation",
abstract = "Background Radio frequency catheter ablation (RFCA) targeting the left ventricular postero septum (LVPS) and posterior papillary muscle (PPM) terminates or prevents ventricular fibrillation (VF) in rabbit and dog hearts. However, whether the mechanism of VF maintenance is reentry or focal Purkinje firing is unclear. Methods and Results In the present study the effects of RFCA (endocardial ablation of PPM+LVPS in 7 dogs and 7 swine), left ventricular anterolateral wall ablation (LVAL in 7 dogs), and the cut-and-sew operation (CSO: along the left ventricular posterior wall (LVPW) beside PPM in 7 swine) on VF inducibility were compared. (1) VF inducibility was decreased from 100±0{\%} to 21.9±31.2{\%} (p<0.0001) by PPM+LVPS endocardial ablation, but not by LVAL ablation in dogs. (2) LVPW CSO reduced VF inducibility (100±0{\%} to 43.6±9.5{\%}, p<0.0001) in swine. (3) In contrast to the canine Purkinje network, which is mostly localized to the subendocardium, the swine Purkinje network extends to the subepicardial layer with a higher density (p<0.001). Conclusion Both PPM+LVPS ablation (Purkinje destruction) in dogs and LVPW CSO (blocking reentry) in swine reduce VF inducibility, suggesting that in both species focal firing from the Purkinje network and reentry around the PPM contributes to the maintenance of VF. (Circ J 2008; 72: 1185-1192).",
author = "huinam pak and Gwang Kim and Lim, {Hong Euy} and Fang, {Yong Hu} and Jong Choi and Kim, {Jin Seok} and Chun Hwang and Kim, {Young Hoon}",
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doi = "10.1253/circj.72.1185",
language = "English",
volume = "72",
pages = "1185--1192",
journal = "Circulation Journal",
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publisher = "Japanese Circulation Society",
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Both Purkinje cells and left ventricular posteroseptal reentry contribute to the maintenance of ventricular fibrillation in open-chest dogs and swine - effects of catheter ablation and the ventricular cut-and-sew operation. / pak, huinam; Kim, Gwang; Lim, Hong Euy; Fang, Yong Hu; Choi, Jong; Kim, Jin Seok; Hwang, Chun; Kim, Young Hoon.

In: Circulation Journal, Vol. 72, No. 7, 15.07.2008, p. 1185-1192.

Research output: Contribution to journalArticle

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AU - pak, huinam

AU - Kim, Gwang

AU - Lim, Hong Euy

AU - Fang, Yong Hu

AU - Choi, Jong

AU - Kim, Jin Seok

AU - Hwang, Chun

AU - Kim, Young Hoon

PY - 2008/7/15

Y1 - 2008/7/15

N2 - Background Radio frequency catheter ablation (RFCA) targeting the left ventricular postero septum (LVPS) and posterior papillary muscle (PPM) terminates or prevents ventricular fibrillation (VF) in rabbit and dog hearts. However, whether the mechanism of VF maintenance is reentry or focal Purkinje firing is unclear. Methods and Results In the present study the effects of RFCA (endocardial ablation of PPM+LVPS in 7 dogs and 7 swine), left ventricular anterolateral wall ablation (LVAL in 7 dogs), and the cut-and-sew operation (CSO: along the left ventricular posterior wall (LVPW) beside PPM in 7 swine) on VF inducibility were compared. (1) VF inducibility was decreased from 100±0% to 21.9±31.2% (p<0.0001) by PPM+LVPS endocardial ablation, but not by LVAL ablation in dogs. (2) LVPW CSO reduced VF inducibility (100±0% to 43.6±9.5%, p<0.0001) in swine. (3) In contrast to the canine Purkinje network, which is mostly localized to the subendocardium, the swine Purkinje network extends to the subepicardial layer with a higher density (p<0.001). Conclusion Both PPM+LVPS ablation (Purkinje destruction) in dogs and LVPW CSO (blocking reentry) in swine reduce VF inducibility, suggesting that in both species focal firing from the Purkinje network and reentry around the PPM contributes to the maintenance of VF. (Circ J 2008; 72: 1185-1192).

AB - Background Radio frequency catheter ablation (RFCA) targeting the left ventricular postero septum (LVPS) and posterior papillary muscle (PPM) terminates or prevents ventricular fibrillation (VF) in rabbit and dog hearts. However, whether the mechanism of VF maintenance is reentry or focal Purkinje firing is unclear. Methods and Results In the present study the effects of RFCA (endocardial ablation of PPM+LVPS in 7 dogs and 7 swine), left ventricular anterolateral wall ablation (LVAL in 7 dogs), and the cut-and-sew operation (CSO: along the left ventricular posterior wall (LVPW) beside PPM in 7 swine) on VF inducibility were compared. (1) VF inducibility was decreased from 100±0% to 21.9±31.2% (p<0.0001) by PPM+LVPS endocardial ablation, but not by LVAL ablation in dogs. (2) LVPW CSO reduced VF inducibility (100±0% to 43.6±9.5%, p<0.0001) in swine. (3) In contrast to the canine Purkinje network, which is mostly localized to the subendocardium, the swine Purkinje network extends to the subepicardial layer with a higher density (p<0.001). Conclusion Both PPM+LVPS ablation (Purkinje destruction) in dogs and LVPW CSO (blocking reentry) in swine reduce VF inducibility, suggesting that in both species focal firing from the Purkinje network and reentry around the PPM contributes to the maintenance of VF. (Circ J 2008; 72: 1185-1192).

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