A novel approach to mapping the atrial ganglionated plexus network by generating a distribution probability atlas

Journal of Cardiovascular Electrophysiology
Min-Young KimPrapa Kanagaratnam

Abstract

The ganglionated plexuses (GPs) of the intrinsic cardiac autonomic system are implicated in arrhythmogenesis. GP localization by stimulation of the epicardial fat pads to produce atrioventricular dissociating (AVD) effects is well described. We determined the anatomical distribution of the left atrial GPs that influence atrioventricular (AV) dissociation. High frequency stimulation was delivered through a Smart-Touch catheter in the left atrium of patients undergoing atrial fibrillation (AF) ablation. Three dimensional locations of points tested throughout the entire chamber were recorded on the CARTO™ system. Impact on the AV conduction was categorized as ventricular asystole, bradycardia, or no effect. CARTO maps were exported, registered, and transformed onto a reference left atrial geometry using a custom software, enabling data from multiple patients to be overlaid. In 28 patients, 2108 locations were tested and 283 sites (13%) demonstrated (AVD-GP) effects. There were 10 AVD-GPs (interquartile range, 11.5) per patient. Eighty percent (226) produced asystole and 20% (57) showed bradycardia. The distribution of the two groups was very similar. Highest probability of AVD-GPs (>20%) was identified in: inferoseptal portion (41...Continue Reading

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Citations

May 26, 2020·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Richard H ClaytonRodrigo Weber Dos Santos
Sep 22, 2020·Journal of Cardiovascular Electrophysiology·Tolga AksuRakesh Gopinathannair
Feb 13, 2020·Journal of Cardiovascular Electrophysiology·Gurpreet S DhillonRoss J Hunter
Jul 29, 2020·Circulation. Arrhythmia and Electrophysiology·Min-Young KimPrapa Kanagaratnam
May 13, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Tolga AksuKivanc Yalin
Jan 10, 2021·Journal of Cardiovascular Electrophysiology·Belinda SandlerUNKNOWN other members of the Imperial College London, Cardiovascular Study Group/Consortium
May 1, 2021·Journal of Cardiovascular Electrophysiology·Tolga AksuDainius H Pauza
May 15, 2021·Cardiovascular Research·Peter HannaKalyanam Shivkumar

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Software Mentioned

CARTO
AVD
CARTO Tag
GP

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