Correlation between anatomy and electrical activation in canine pulmonary veins

Akira Hamabe, Yuji Okuyama, Yasushi Miyauchi, Shengmei Zhou, Hui Nam Pak, Hrayr S. Karagueuzian, Michael C. Fishbein, Peng Sheng Chen

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Abstract

Background - The roles of complex muscle sleeve geometry and fiber orientation in the pulmonary veins (PVs) in wave-front propagation are poorly understood. Methods and Results - We mapped the left superior PV (LSPV, n=7) and left inferior PV (LIPV, n=4) of dogs with 420 bipolar electrodes (1-mm resolution) and performed detailed histological examination. In the anterior LSPV-left atrial (LA) junction, myocardial muscle fibers were oriented perpendicular to PV blood flow. A wedge filled with connective tissues led to a complete muscle separation or an abrupt increase in muscle thickness between the PV and LA (0.42±0.12 versus 2.0±0.31 mm, P<0.01). Distal LSPV pacing resulted in conduction block at the anterior PV-LA junction, with double potentials. In contrast, the posterior LSPV-LA junction showed gradual muscle thickening and a fiber orientation parallel to the blood flow. The maximum PV muscle thickness in the anterior PV-LA junction is thinner than that in the posterior junction (0.83±0.15 versus 1.3±0.38 mm, P<0.01). Distal LIPV pacing showed multiple PV-LA breakthroughs, with segmental conduction block in the anterior PV-LA junction. The conduction block corresponded to segmental PV-LA muscle disconnection. Complex fiber orientations in the PV muscle sleeves away from the PV-LA junction were responsible for intra-PV conduction delay or block during rapid PV pacing. Conclusions - We conclude that segmental muscle disconnection and differential muscle narrowing at PV-LA junctions and complex fiber orientations within the PV provide robust anatomical bases for conduction disturbance at the PV-LA junction and complex intra-PV conduction patterns.

Original languageEnglish
Pages (from-to)1550-1555
Number of pages6
JournalCirculation
Volume107
Issue number11
DOIs
Publication statusPublished - 2003 Mar 25

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Hamabe, A., Okuyama, Y., Miyauchi, Y., Zhou, S., Pak, H. N., Karagueuzian, H. S., Fishbein, M. C., & Chen, P. S. (2003). Correlation between anatomy and electrical activation in canine pulmonary veins. Circulation, 107(11), 1550-1555. https://doi.org/10.1161/01.CIR.0000056765.97013.5E