Myocardium extending from the left atrium onto the pulmonary veins: a comparison between subjects with and without atrial fibrillation.
Rapid discharges from the myocardium extending from the left atrium onto the pulmonary vein (PV) have been shown to initiate AF, and AF may be eradicated by the catheter ablation within the PV. However, if there is any difference in the distribution patterns of the myocardial sleeve onto the PV betw...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 24; no. 10; pp. 1459 - 1464 |
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| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2001
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106087701&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106087701 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Oct2001 vid: 24 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106087701 2009415492 NLM11707038 106087701 ppf: 1459 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Myocardium extending from the left atrium onto the pulmonary veins: a comparison between subjects with and without atrial fibrillation. aug: au: Tagawa M Higuchi K Chinushi M Washizuka T Ushiki T Ishihara N Aizawa Y sug: subj: Atrial Fibrillation Pathology Heart Atrium Anatomy and Histology Myocardium Pathology Pulmonary Veins Anatomy and Histology Aged Female Male Aged: 65+ years Female Male ab: Rapid discharges from the myocardium extending from the left atrium onto the pulmonary vein (PV) have been shown to initiate AF, and AF may be eradicated by the catheter ablation within the PV. However, if there is any difference in the distribution patterns of the myocardial sleeve onto the PV between the subjects with and without AF is to be determined. Twenty-one autopsied hearts were examined. Eleven patients previously had AF before death and another 10 patients had normal sinus rhythm as confirmed from the medical records including ECGs before death. After exposing the heart, the distance to the peripheral end of the myocardium was measured from the PV-atrial junction in each PV. Then, the PVs were sectioned and stained and the distal end of myocardium and the distribution pattern were studied. The anteroposterior diameter of the left atrium was also measures. In 74 of 84 PVs, the myocardium extended beyond the PV-atrial junction. The myocardium was localized surrounding the vascular smooth muscle layer forming a myocardial sleeve. The peripheral end of the myocardial sleeve was irregular and the maximal and minimal distances were measured in each PV. The myocardium extended most distally in the superior PVs compared to the inferior ones and the maximal distance to the peripheral end was similar between the AF and non-AF subjects (8.4 ± 2.8 vs 8.7 ± 4.4 mm for the left superior and 6.5 ± 3.5 vs 5.1 ± 3.9 mm for the right superior PV, respectively). A significant difference was found in the maximal distance in the inferior PVs: 7.3 ± 4.6 vs 3.3 ± 2.8 mm for the left (P <0.05) and 5.7 ± 2.4 vs 1.7 ± 1.9 mm for the right inferior PV (P <0.001) in the subjects with and without AF, respectively. The diameter of left atrium was slightly dilated in AF patients but insignificantly (4.1 ± 0.1 vs 3.6 ± 0.1 cm, P > 0.07). The myocytes on the PV were less uniform and surrounded by more fibrosis in patients with AF compared to those without AF. In conclusion, the myocardium extended beyond the atrium-vein junction onto the PVs. The distribution patterns of the myocardium was almost similar between subjects with and without AF, but the histology suggested variable myocytes in size and fibrosis in patients with AF. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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