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Neural Control of Ventricular Rate in Ambulatory Dogs with Pacing Induced Sustained Atrial Fibrillation
전남대학교병원 순환기내과1, Krannert Institute of Cardiology, the Division of Cardiology, Department of Medicine2, Department of Biostatistics 3, Department of Neurology4, Indiana University School of Medicine, IN, Central Utah Medical Clinic Cardiology – Utah Valley Regional Medical Center, UT5
박형욱1, Mark J. Shen2, Seongwook Han2, Tetsuji Shinohara2, Mitsunori Maruyama2, Young-Soo Lee2, Changyu Shen3, Lan S. Chen4, Chun Hwang5, , 조정관1, Shien-Fong Lin2, Peng-Sheng Chen2
Background — We hypothesize that inferior vena cava-inferior atrial ganglionated plexus nerve activity (IVC-IAGPNA) is responsible for the ventricular rate (VR) control during atrial fibrillation (AF) in ambulatory dogs. Methods and Results — We recorded bilateral cervical vagal nerve activity (VNA) and IVC-IAGPNA during baseline sinus rhythm and during pacing-induced sustained AF in 6 ambulatory dogs. Integrated nerve activities and average VR were measured every 10-s over 24-hour periods. LVNA was associated with VR reduction during AF in 5 dogs (from 211±28 bpm to 178±38 bpm, p<0.001) and RVNA in 1 dog (from 208±21 bpm to 181±23 bpm, p<0.01). There were good correlations between IVC-IAGPNA and LVNA in the former 5 dogs (average r of 0.792±0.103, p<0.05 in all), and between IVC-IAGPNA and RVNA in the latter dog (r=0.773, p<0.05). IVC-IAGPNA was associated with VR reduction in all dogs studied (r=-0.404±0.102, p<0.05). Average VR during AF was 184±45 bpm (67 bpm – 269 bpm). The average VR during IVC-IAGP discharges was 168±46 bpm, while the average VR without IVC-IAGP discharges was 194±46 bpm (p<0.001). RVNA was associated with baseline sinus rate reduction (from 105±21 bpm to 77±15 bpm, p<0.01) in 4 dogs and LVNA in 2 dogs (from 111±18 bpm to 81±18 bpm, p<0.01). Conclusions — IVC-IAGPNA is invariably associated with VR reduction during AF. On the other hand, right or left VNA was associated with VR reduction only when it co-activates with the IVC-IAGPNA. The VNA that controls VR during AF may be different than the VNA that controls baseline sinus rhythm.


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