Jan 1, 1990

Modification of atrioventricular conduction by selective AV nodal artery catheterization

Pacing and Clinical Electrophysiology : PACE
P J WangP L Friedman

Abstract

The effects of selective AV nodal artery embolization on AV nodal function was investigated in six closed-chest adult dogs. Programmed atrial stimulation was performed to determine control values for AV nodal effective refractory period (AVN-ERP) and the paced cycle length at which AV nodal Wenckebach conduction occurred (WCL). Using standard percutaneous femoral techniques of coronary artery catheterization, a flexible infusion catheter was positioned selectively in the AV nodal artery. Proper positioning of the catheter was confirmed angiographically and by selective acetylcholine (ACH) infusion into the AV nodal artery, which caused transient complete AV nodal block in three dogs, and for the group, caused lengthening of both AVN-ERP and WCL. Following cessation of ACH infusion and autonomic blockade with atropine 0.04 mg/kg and propranolol 0.2 mg/kg, denervated recontrol values for AVN-ERP and WCL were 192 msec and 243 msec, respectively. The AV nodal artery was then embolized with a suspension of cross-linked collagen fibrils in either normal saline or absolute ethanol. Successful embolization of the AV nodal artery, confirmed angiographically, caused an acute increase in AVN-ERP (243 msec, P less than 0.05 compared to den...Continue Reading

Mentioned in this Paper

Myocardial Contraction
Ethanol
Supraventricular Tachycardia
Heart Block
Normal saline
Crista Terminalis Branch of Sinoatrial Nodal Artery
Myasthenic Syndrome, Congenital, Associated With Acetylcholine Receptor Deficiency
Denatured Absolute Ethanol
Refractory Period, Electrophysiological
Entire Coronary Artery

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