| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Division of Cardiology, Department of Medicine, and the Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Submitted 2 February 2007 ; accepted in final form 31 May 2007
The objective of the study was to investigate the morphology, distribution, and electrophysiological profile of the autonomic fibers that innervate the ligament of Marshall (LOM). Gross anatomical dissections were performed in 10 dogs. Sections of the left vagus nerve, left stellate ganglion, and the LOM were immunostained to identify adrenergic and cholinergic nerves. Hearts were also stained for acetylcholinesterase to identify epicardial cholinergic nerves. In vivo electropyhsiological studies were performed in another 10 dogs before and after LOM ablation. The anatomical examination revealed that the LOM is innervated by a branch of the left vagus. Immunohistochemistry confirmed that these nerve bundles are predominantly cholinergic (cholinergic-to-adrenergic ratio of 12.6 ± 3.9:1). Cholinergic nerves originating in the LOM were found to innervate surrounding left atrial structures, including the pulmonary veins, left atrial appendage, coronary sinus, and posterior left atrial fat pad. Ablation of the LOM significantly attenuated effective refractory period shortening at distant sites, such as pulmonary veins and left atrial appendage, in response to vagal stimulation (vagal-induced ERP decrease in the left atrium: baseline vs. postablation = 17 vs. 4%; P = 0.0056). In conclusion, the LOM contains a predominance of cholinergic nerve fibers. Cholinergic fibers arising from the LOM innervate surrounding structures and contribute to the electrophysiological profile of the left atrium. These findings may provide a basis for the role of the LOM in the genesis and maintenance of atrial fibrillation.
ablation; arrhythmia (mechanisms); autonomic nervous system; innervation; supraventricular arrhythmia
This article has been cited by other articles:
|
|
 |
|
  Z. Lu, B. J. Scherlag, J. Lin, L. Yu, J.-H. Guo, G. Niu, W. M. Jackman, R. Lazzara, H. Jiang, and S. S. Po Autonomic mechanism for initiation of rapid firing from atria and pulmonary veins: evidence by ablation of ganglionated plexi Cardiovasc Res, July 4, 2009; (2009) cvp194v2. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. L. Aistrup, R. Villuendas, J. Ng, A. Gilchrist, T. W. Lynch, D. Gordon, I. Cokic, S. Mottl, R. Zhou, D. A. Dean, et al. Targeted G-protein inhibition as a novel approach to decrease vagal atrial fibrillation by selective parasympathetic attenuation Cardiovasc Res, June 8, 2009; (2009) cvp148v2. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Katritsis, E. Giazitzoglou, D. Sougiannis, E. Voridis, and S. S. Po Complex fractionated atrial electrograms at anatomic sites of ganglionated plexi in atrial fibrillation Europace, March 1, 2009; 11(3): 308 - 315. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Valderrabano, H. R. Chen, J. Sidhu, L. Rao, Y. Ling, and D. S. Khoury Retrograde Ethanol Infusion in the Vein of Marshall: Regional Left Atrial Ablation, Vagal Denervation, and Feasibility in Humans Circ Arrhythmia Electrophysiol, February 1, 2009; 2(1): 50 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Cabrera, S. Y. Ho, V. Climent, and D. Sanchez-Quintana The architecture of the left lateral atrial wall: a particular anatomic region with implications for ablation of atrial fibrillation Eur. Heart J., February 1, 2008; 29(3): 356 - 362. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |
