Structural and electro-anatomical characterization of the equine pulmonary veins: implications for atrial fibrillation.

Autor: Kjeldsen ST; Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark. Electronic address: sofie.troest@sund.ku.dk., Nissen SD; Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark., Saljic A; Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark., Hesselkilde EM; Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark., Carstensen H; Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark., Sattler SM; Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark., Jespersen T; Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark., Linz D; Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Universiteitssingel 50, 632, 6229 ER Maastricht, Netherlands., Hopster-Iversen C; Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark., Kutieleh R; Abbott Medical, 214 Greenhill Road, SA 5063, Australia., Sanders P; Centre for Heart Rhythm Disorders, Royal Adelaide Hospital and University of Adelaide, Port Rd, SA 5000, Australia., Buhl R; Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark.
Jazyk: angličtina
Zdroj: Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology [J Vet Cardiol] 2024 Apr; Vol. 52, pp. 1-13. Date of Electronic Publication: 2024 Jan 06.
DOI: 10.1016/j.jvc.2024.01.001
Abstrakt: Introduction/objectives: Spontaneous pulmonary vein (PV) activity triggers atrial fibrillation (AF) in humans. Although AF frequently occurs in horses, the origin remains unknown. This study investigated the structural and electro-anatomical properties of equine PVs to determine the potential presence of an arrhythmogenic substrate.
Animals, Materials and Methods: Endocardial three-dimensional electro-anatomical mapping (EnSite Precision) using high-density (HD) catheters was performed in 13 sedated horses in sinus rhythm. Left atrium (LA) access was obtained retrogradely through the carotid artery. Post-mortem, tissue was harvested from the LA, right atrium (RA), and PVs for histological characterization and quantification of ion channel expression using immunohistochemical analysis.
Results: Geometry, activation maps, and voltage maps of the PVs were created and a median of four ostia were identified. Areas of reduced conduction were found at the veno-atrial junction. The mean myocardial sleeve length varied from 28 ± 13 to 49 ± 22 mm. The PV voltage was 1.2 ± 1.4 mV and lower than the LA (3.4 ± 0.9 mV, P < 0.001). The fibrosis percentage was higher in PV myocardium (26.1 ± 6.6%) than LA (14.5 ± 5.0%, P = 0.003). L-type calcium channel (Ca V 1.2) expression was higher in PVs than LA (P = 0.001). T-type calcium channels (Ca V 3.3), connexin-43, ryanodine receptor-2, and small conductance calcium-activated potassium channel-3 was expressed in PVs.
Conclusions: The veno-atrial junction had lower voltages, increased structural heterogeneity and areas of slower conduction. Myocardial sleeves had variable lengths, and a different ion channel expression compared to the atria. Heterogeneous properties of the PVs interacting with the adjacent LA likely provide the milieu for re-entry and AF initiation.
Competing Interests: Conflict of Interest Statement Mr Kutieleh is an employee of Abbott Medical, Australia. Dr Sanders reports having served on the advisory board of Boston Scientific, CathRx, Medtronic, Abbott Medical and Pacemate. Dr Sanders reports that the University of Adelaide has received on his behalf lecture and/or consulting fees from Medtronic, Boston-Scientific, and Abbott Medical, Pacemate and CathRx. Dr Sanders reports that the University of Adelaide has received on his behalf research funding from Medtronic, Abbott Medical, Boston-Scientific, Pacemate, Becton Dickinson and Microport. The remaining authors do not have any conflict of interest to disclose.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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