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Cited 29 time in webofscience Cited 33 time in scopus
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Both Purkinje cells and left ventricular posteroseptal reentry contribute to the maintenance of ventricular fibrillation in open-chest dogs and swine - Effects of catheter ablation and the ventricular cut-and-sew operation

Authors
Pak, Hui-NamKim, Gwang IlLim, Hong EuyFang, Yong HuChoi, Jong IlKim, Jin SeokHwang, ChunKim, Young-Hoon
Issue Date
Jul-2008
Publisher
JAPANESE CIRCULATION SOC
Keywords
catheter ablation; cut-and-sew operation; papillary muscle; Purkinje; ventricular fibrillation
Citation
CIRCULATION JOURNAL, v.72, no.7, pp 1185 - 1192
Pages
8
Indexed
SCIE
SCOPUS
Journal Title
CIRCULATION JOURNAL
Volume
72
Number
7
Start Page
1185
End Page
1192
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/16905
DOI
10.1253/circj.72.1185
ISSN
1346-9843
1347-4820
Abstract
Background Radiofrequency catheter ablation (RFCA) targeting the left ventricular posteroseptum (LVPS) and posterior papillary muscle (PPM) terminates or prevents ventricular fibrillation (VF) in rabbit and dog hearts. However, whether the mechanism of VF maintenance is reentry or focal Purkinje firing is unclear. Methods and Results In the present study the effects of RFCA (endocardial ablation of PPM+LVPS in 7 dogs and 7 swine), left ventricular anterolateral wall ablation (LVAL in 7 dogs), and the cut-and-sew operation (CSO: along the left ventricular posterior wall (LVPW) beside PPM in 7 swine) on VF inducibility were compared. (1) VF inducibility was decreased from 100 +/- 0% to 21.9 +/- 31.2% (p<0.0001) by PPM+LVPS endocardial ablation, but not by LVAL ablation in dogs. (2) LVPW CSO reduced VF inducibility (100 +/- 0% to 43.6 +/- 9.5%, p<0.0001) in swine. (3) In contrast to the canine Purkinje network, which is mostly localized to the subendocardium, the swine Purkinje network extends to the subepicardial layer with a higher density (p<0.001). Conclusion Both PPM+LVPS ablation (Purkinje destruction) in dogs and LVPW CSO (blocking reentry) in swine reduce VF inducibility, suggesting that in both species focal firing from the Purkinje network and reentry around the PPM contributes to the maintenance of VF.
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