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(Circulation. 2008;118:897-898.)
© 2008 American Heart Association, Inc.

Clinical Summaries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Cardiac Memory in Patients With Wolff-Parkinson-White Syndrome: Noninvasive Imaging of Activation and Repolarization Before and After Catheter Ablation

 
ECG imaging, a noninvasive imaging modality for cardiac electrophysiology, determines the locations of Wolff-Parkinson-White accessory pathways with greater accuracy than the conventional ECG-based Arruda algorithm. This capability makes ECG imaging an effective tool for guiding accessory pathway ablation procedures, possibly shortening their time and reducing the associated iatrogenic risks. ECG imaging also can be used to evaluate the outcome of ablation. The study shows that persistent preexcitation, which constitutes a natural model for prolonged ventricular pacing from the accessory pathway insertion site, leads to high dispersion of repolarization and a prolonged activation-recovery interval (action potential duration) at the preexcited (paced) region. The abnormal repolarization gradients resolve over a period of 1 month after a return to normal sinus rhythm by successful ablation. This time course is consistent with long-term cardiac memory, possibly involving transcriptional changes that trigger remodeling processes that alter the molecular determinants of action potential duration. The results of this study may apply to other clinical situations like cardiac pacing in which a high dispersion of repolarization in a structurally abnormal heart might provide a possible mechanistic basis of pacing-induced proarrhythmia reported in the literature. See p 907.

	Neural Mechanisms of Paroxysmal Atrial Fibrillation and Paroxysmal Atrial Tachycardia in Ambulatory Canines

 
Paroxysmal atrial fibrillation (PAF) is a common cardiac arrhythmia. In the present study, we developed a canine model of PAF induced by intermittent rapid atrial pacing. Continuous autonomic nerve recordings showed that simultaneous sympathovagal discharge is a common trigger for PAF in this model. Cryoablation of the stellate ganglion and cardiac branch of the vagal nerve prevented PAF. A . . . [Full Text of this Article]

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