Left atrial ganglionated plexi detection is related to heart rate and early recurrence of atrial fibrillation after surgical ablation

Abstract INTRODUCTION: Left atrial ganglionated plexi ablation is an adjuvant technique used to increase the success rate of surgical ablation of atrial fibrillation. Ganglionated plexi ablation requires previous detection. We aimed to assess determinants of successful ganglionated plexi detection and to correlate range of ganglionated plexi ablation with risk of early atrial fibrillation recurrence. METHODS: The study involved 34 consecutive patients referred for surgical coronary revascularization with concomitant atrial fibrillation ablation. Ganglionated plexi detection was done by inducing vagal reflexes in the area of the pulmonary veins and left atrial fat pads. RESULTS: Detection of GP was successful in 85% of the patients. There was no difference in preoperative characteristics nor in atrial fibrillation type between patients in whom ganglionated plexi detection was successful and others. The number of detected ganglionated plexi correlated significantly only with preoperative resting heart rate. Significant negative correlation was found in patients with preoperative heart rate>75 beat/min in terms of total number of detected ganglionated plexi (P=0.04). Average number of detected ganglionated plexi was significantly higher in patients with in-hospital atrial fibrillation recurrence requiring electrical cardioversion (3.8±3) in comparison to rest of the study population (2±1.3; P=0.02). In patients in whom 4 or more ganglionated plexi were detected, significantly increased risk of in-hospital atrial fibrillation recurrence was observed (OR 15; 95% CI 1.5-164; P=0.003). CONCLUSION: Left atrial ganglionated plexi detection was unsuccessful in a considerable percentage of patients. Preoperative heart rate significantly influenced positive ganglionated plexi detection and number of ablated ganglia. Higher number of detected ganglionated plexi was related with early recurrence of atrial fibrillation.

Relationship between right atrium ganglionated plexus and atrial fibrillation: A new canine model for sustained focal atrial fibrillation / 中国介入心脏病学杂志

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Regulatory effect of Zn~(2+) on P2X receptor-mediated,ATP-induced currents in different autonomic ganglion neurons in rats / 第二军医大学学报

Objective:To compare the effects of Zn~(2+)onthe P2X receptor-mediated,ATP-induced currents in neurons separated from rat superior cervical ganglion(SCG),nodose ganglion(NG),and otic ganglion(OTG).Methods: Whole-cell patch clamp recording technique was used to study the regulatory effects of Zn~(2+) on ATP/??-me ATP-induced currents in the above 3 ganlglion neurons.Results: All SCG neurons responded to ATP with a sustained current,while no neurons responded to ??-me ATP;Zn~(2+) potentiated ATP-induced sustained currents to(1 442?34)% of the original value.All NG neurons responded to ATP and ??-me ATP with a similar sustained current;coapplication of Zn~(2+)(10 ?mol/L) potentiated their responses to(180?12)% and(262?28)%,respectively.All OTG neurons responded to both ATP and ??-me ATP with a sustained current.Coapplication of Zn~(2+)(10 ? mol/L) did not significantly potentiate the sustained currents induced by 10 ?mol/L ATP,but when ATP was at 30 ?mol/L,Zn~(2+)(10-100 ?mol/L) inhibited ATP-induced sustained currents in a dose dependent manner.If TNP-ATP(100 nmol/L) was first used to inhibit ATP-induced current to(26?2)% of the original value,Zn~(2+) at 10 ?mol/L potentiated the inhibited current to(127?9)% of its original value.Coapplication of Zn~(2+)(10 ?mol/L) potentiated ??-me ATP-induced currents to(146?5)% of the control.Zn~(2+)(300 ?mol/L) had no effect on ?_(on) and ?_(off) of ATP-and ??-me ATP-induced(30 ?mol/L) currents in OTG neurons.Conclusion:(1) Zn~(2+) is an allosteric modulator of P2X_(2) and P2X_(2/3) receptors in SCG and NG neurons and can potentiate the currents they induced.(2)The predominant receptor subtypes in OTG appear to be homomeric P2X_(2/3) and a little P2X_(2).Zn~(2+) has an inhibitory effect on the ATP-induced currents in OTG neurons,suggesting some novel members of the P2X purinoceptor exist in these neurons.