首页   按字顺浏览 期刊浏览 卷期浏览 Fluorescent Imaging of a Dual-Pathway Atrioventricular-Nodal Conduction System
Fluorescent Imaging of a Dual-Pathway Atrioventricular-Nodal Conduction System

 

作者: Vladimir Nikolski,   Igor Efimov,  

 

期刊: Circulation Research: Journal of the American Heart Association  (OVID Available online 2001)
卷期: Volume 88, issue 3  

页码: 23-30

 

ISSN:0009-7330

 

年代: 2001

 

出版商: OVID

 

关键词: ablation;electrophysiology;arrhythmia;imaging

 

数据来源: OVID

 

摘要:

Abstract—A dual-pathway theory to explain atrioventricular-nodal (AVN) reentry has been proposed previously. However, the exact anatomical and functional correlates of the fast pathway (FP) and slow pathway (SP) have not yet been elucidated. We used optical mapping to reconstruct patterns of activation during retrograde conduction through the AVN and during AVN reentry in the triangles of Koch of 12 rabbits. Reentry was inducible by a premature stimulation of the bundle of His in 6 preparations (50%). A functional FP and SP appear to be anatomically correlated with posterior and posterolateral extensions of the AVN, which were recently described. Retrograde breakthrough points in 6 noninducible preparations were clustered near the apex of the triangle of Koch (FP), whereas 6 inducible preparations had either cycle length–dependent FP and SP exits (n=3) or only SP exits located near the coronary sinus orifice. The shift of breakthrough points from FP to SP during progressive shortening of the coupling interval was accompanied by a discontinuity in the conduction curve. We observed a transmural reentrant circuit involving the AVN, FP, SP, and the superficial endocardial layer of atrial and transitional cells. The presence of a functional SP during retrograde conduction was associated with inducibility of AVN reentry. The full text of this article is available at http://www.circresaha.org.

 

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