Vagal effects on sinoatrial and atrial conduction studied with epicardial mapping in dogs: the influence of pacemaker shifts on the measurement of sinoatrial conduction time

1985 ◽  
Vol 63 (2) ◽  
pp. 113-121 ◽  
Author(s):  
Hidehiko Watanabe ◽  
Jean-Benoît Perry ◽  
Pierre Pagé ◽  
Pierre Savard ◽  
Réginald Nadeau
Keyword(s):  
Conduction Velocity ◽  
Vagal Stimulation ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Atrial ◽  
Conduction Time ◽  
Atrial Conduction Time ◽  
Pacemaker Shift ◽  
Atrial Conduction Times ◽  
Recording Electrodes

The influence of pacemaker shifts on sinoatrial conduction time (SACT) was studied by investigating the effects of vagal stimulation on SACT and atrial conduction in anesthetized open-chest dogs. Isochronal maps were drawn from unipolar electrograms simultaneously recorded at 60 epicardial sites on the right atrial free wall and the inferior and superior vena cava. Vagal stimulation caused atrial conduction velocity to increase from 0.99 ± 0.10 m/s (mean ± SD) to 1.23 ± 0.23 m/s (p < 0.01), and the pacemaker to shift to lower positions along the superior vena cava – right atrial junction. As a result of the changes, the distances and the atrial conduction times from the stimulating and recording electrodes to the pacemaker site varied, and hence, the SACT values obtained indirectly by premature atrial stimulation varied. The isochronal maps were used to measure the atrial conduction times from stimulating to recording electrodes (a), from stimulating electrode to pacemaker site (b), and from pacemaker site to recording electrode (c). Indirect SACT was lengthened by vagal stimulation from 43 ± 16 to 64 ± 22 ms (p < 0.02). After correcting by subtracting the atrial conduction time (b + c − a), these values became 26 ± 6 ms (control) and 40 ± 11 ms (vagal stimulation) (p < 0.01). SACT values measured directly from the electrograms were 27 ± 7 ms (control) and 42 ± 10 ms (vagal stimulation) (p < 0.01). Corrected indirect SACTs were closer to direct SACTs than were the uncorrected indirect SACTs. It was concluded that (i) vagal stimulation induced pacemaker shift, increased atrial conduction velocity, and prolonged SACT; (ii) constant atrial pacing induced a pacemaker shift toward the stimulating electrode; and (iii) atrial conduction time must be taken into account to correctly estimate SACT.

Single-Patch Fold-Back Technique for Augmentation of the Superior Vena Cava in Sinus Venosus Atrial Septal Defect Associated with Partial Anomalous Pulmonary Venous Return

2015 ◽  
Vol 17 (6) ◽  
pp. 282
Author(s):  
Suguru Ohira ◽  
Kiyoshi Doi ◽  
Takeshi Nakamura ◽  
Hitoshi Yaku
Keyword(s):  
Atrial Septal Defect ◽  
Superior Vena Cava ◽  
Septal Defect ◽  
Venous Return ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Sinus Venosus ◽  
Right Atrial ◽  
Anomalous Pulmonary Venous Return

Sinus venosus atrial septal defect (ASD) is usually associated with partial anomalous pulmonary venous return (PAPVR) of the right pulmonary veins to the superior vena cava (SVC), or to the SVC-right atrial junction. Standard procedure for repair of this defect is a patch roofing of the sinus venosus ASD and rerouting of pulmonary veins. However, the presence of SVC stenosis is a complication of this technique, and SVC augmentation is necessary in some cases. We present a simple technique for concomitant closure of sinus venosus ASD associated with PAPVR and augmentation of the SVC with a single autologous pericardial patch.

Increased cardiac output following occlusion of the descending thoracic aorta in dogs

1982 ◽  
Vol 243 (1) ◽  
pp. R152-R158 ◽  
Author(s):  
J. K. Stene ◽  
B. Burns ◽  
S. Permutt ◽  
P. Caldini ◽  
M. Shanoff
Keyword(s):  
Cardiac Output ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Thoracic Aorta ◽  
Vascular System ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Atrial ◽  
Mean Systemic Pressure ◽  
Extracorporeal Bypass

Occlusion of the thoracic aorta (AO) in dogs with a constant volume right ventricular extracorporeal bypass increased cardiac output (Q) by 43% and mean arterial pressure by 46%, while mean systemic pressure (MSP) was unchanged. We compared AO with occlusion of the brachiocephalic and left subclavian arteries (BSO) which decreased cardiac output by 5%, increased mean arterial pressure by 32%, and increased MSP by 11%. We feel these results confirm that AO elevates preload by transferring blood volume from the splanchnic veins to the vascular system drained by the superior vena cava. If the heart is competent to keep right arterial pressure at or near zero, this increase in preload will elevate Q above control levels. Comparing our data with results of other authors who have not controlled right atrial pressure, emphasizes the importance of a competent right ventricle in allowing venous return to determine Q.

Influence of right atrial stretch on plasma renin activity in the conscious rat

1987 ◽  
Vol 65 (2) ◽  
pp. 257-259 ◽  
Author(s):  
Susan Kaufman
Keyword(s):  
Plasma Renin Activity ◽  
Superior Vena ◽  
Vena Cava ◽  
Extracellular Fluid ◽  
Plasma Renin ◽  
Renin Activity ◽  
Right Atrial ◽  
Balloon Inflation ◽  
Conscious Rat ◽  
Basal Plasma

Rats were prepared with inflatable balloons at the superior vena cava – right atrium junction. After recovery 1 week later, when blood was taken from conscious, normovolaemic animals plasma renin activity was found not to be influenced by right atrial stretch. Plasma renin activity was then measured in rats in which an extracellular fluid deficit had been produced by peritoneal dialysis against a hyperoncotic, isotonic solution. Although basal plasma renin activity was elevated (6.8 ± 0.9 from 1.5 ± 0.2 ng∙mL∙h, n = 19), no depression was observed in the experimental group after 15 or 90 min of balloon inflation. In rats pretreated with isoprenaline (10 μg/kg body wt.) plasma renin activity was also increased over basal levels, but again balloon inflation caused no reduction in plasma renin activity. It would appear that right atrial stretch has little, if any, influence on renin release in the conscious rat.

Selective parasympathectomy of automatic and conductile tissues of the canine heart

1985 ◽  
Vol 248 (1) ◽  
pp. H61-H68 ◽  
Author(s):  
W. C. Randall ◽  
J. L. Ardell
Keyword(s):  
Vagal Stimulation ◽  
Superior Vena ◽  
Sympathetic Innervation ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Dorsal Surface ◽  
Atrial Pacing ◽  
Canine Heart ◽  
Surgical Interventions ◽  
The Right

From right thoracotomy (T4-T5), the canine heart was suspended in its pericardium to expose its major venous inputs. Vagal and sympathetic trunks were prepared for electrical stimulation (10-20 Hz, 5.0 ms, 3-5 V) before and after each separate denervation procedure. Vagal stimulation was instituted with and without concurrent atrial pacing. The following surgical interventions were performed. 1) The superior vena cava was cleared of connective and nervous tissues from the pericardial reflection caudally to the level of the right pulmonary artery. 2) The azygos vein was cleared, tied, and sectioned. 3) The right pulmonary veins were isolated and cleared intrapericardially. 4) The dorsal surface of the atria was dissected between the right and left pulmonary veins and painted with phenol. Each step in the procedure elicited successive stepwise deletion of parasympathetic influences on sinoatrial tissues of the canine heart with only minor ablation of sympathetic inputs. 5) Dissection of the triangular fat pad at the junction of the inferior vena cava and inferior left atrium eliminated the remaining parasympathetic efferent input to the heart with dramatic deletion of atrioventricular block during either left or right vagal stimulation, again with preservation of most of the sympathetic innervation. These experiments clearly demonstrate differential and selective inputs of parasympathetic pathways to sinoatrial (SAN) and atrioventricular (AVN) regions of the dog heart but relatively little interference with sympathetic distributions.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Recurrent cardiac hydatid cyst located near the root of the superior vena cava and the interatrial septum: a case report

2022 ◽  
pp. 1-4
Author(s):  
Redha Lakehal ◽  
Farid Aymer ◽  
Soumaya Bendjaballah ◽  
Rabah Daoud ◽  
Khaled Khacha ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Facial Paralysis ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Lower Lobe ◽  
Lateral Wall ◽  
Right Atrial ◽  
Risk Of Rupture ◽  
The Right

Introduction: Cardiac localization of hydatid disease is rare (<3%) even in endemic countries. Affection characterized by a long functional tolerance and a large clinical and paraclinical polymorphism. Serious cardiac hydatitosis because of the risk of rupture requiring urgent surgery. The diagnosis is based on serology and echocardiography. The aim of this work is to show a case of recurrent cardiac hydatid cyst discovered incidentally during a facial paralysis assessment. Methods: We report the observation of a 26-year-old woman operated on in 2012 for pericardial hydatid cyst presenting a cardiac hydatid cyst located near the abutment of the SCV discovered incidentally during an exploration for left facial paralysis: NYHA stage II dyspnea. Chest x-ray: CTI at 0.48. ECG: RSR. Echocardiography: Image of cystic appearance at the level of the abutment of the SVC. SAPP: 38 mmhg, EF: 65%. Thoracic scan: 30/27 mm cardiac hydatid cyst bulging the lateral wall of the right atrium and the trunk of the right pulmonary artery with fissured cardiac hydatid cyst of the apical segment of the right lung of the right lower lobe with multiple bilateral intra parenchymal and sub pleural nodules. The patient was operated on under CPB. Intraoperative exploration: Presence of a hard and whitish mass, about 03 / 03cm developed in the full right atrial wall opposite the entrance to the superior vena cava. Procedure: Resection of the mass removing the roof of the LA, the AIS and the wall of the RA with reconstruction of the roof of the RA by patch in Dacron and reconstruction of the IAS and the wall of the RA by a single patch in Dacron. Results: The postoperative suites were simple. Conclusion: The hydatid cyst is still a real endemic in Algeria, the cardiac location is rare but serious and can constitute a real surgical emergency, hence the importance of prevention. Keywords: Hydatid cyst of the heart; Recurrence; Surgery; Cardiopulmonary Bypass; Prevention

Central Venous Catheter Complications

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 865-866
Author(s):  
JACK L. DOLCOURT ◽  
CARL L. BOSE
Keyword(s):  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Clinical Signs ◽  
Venous Catheter ◽  
Upper Body ◽  
Right Atrial ◽  
Catheter Complications ◽  
Vena Cava Syndrome ◽  
Central Venous Catheter Complications

In Reply.— We thank Hoelzer and L'Hommedieu for their comments and for pointing out that subclavian catheters are capable of lasting as long as the percutaneously placed central Silastic catheter (PCSC).1,2 The median duration for PCSC usage in our series3 was 21 days. For us, the diagnosis of superior vena cava syndrome is only suspected in the presence of differential upper body edema. The diagnosis of right atrial thrombosis is not likely to be made by us without clinical signs of venous obstruction as echocardiograms are not routinely performed.

Inotropic, chronotropic, and dromotropic effects mediated via parasympathetic ganglia in the dog heart

2000 ◽  
Vol 279 (3) ◽  
pp. H1201-H1207 ◽  
Author(s):  
Masato Tsuboi ◽  
Yasuyuki Furukawa ◽  
Koichi Nakajima ◽  
Fumio Kurogouchi ◽  
Shigetoshi Chiba
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Contractile Force ◽  
Right Atrial ◽  
Fat Pad ◽  
Parasympathetic Ganglia ◽  
Dog Heart ◽  
Parasympathetic Nerves ◽  
Av Conduction ◽  
Stimulation Of

Some parasympathetic ganglionic cells are located in the epicardial fat pad between the medial superior vena cava and the aortic root (SVC-Ao fat pad) of the dog. We investigated whether the ganglionic cells in the SVC-Ao fat pad control the right atrial contractile force, sinus cycle length (SCL), and atrioventricular (AV) conduction in the autonomically decentralized heart of the anesthetized dog. Stimulation of both sides of the cervical vagal complexes (CVS) decreased right atrial contractile force, increased SCL, and prolonged AV interval. Stimulation of the rate-related parasympathetic nerves to the sinoatrial (SA) node (SAPS) increased SCL and decreased atrial contractile force. Stimulation of the AV conduction-related parasympathetic nerves to the AV node prolonged AV interval. Trimethaphan, a ganglionic nicotinic receptor blocker, injected into the SVC-Ao fat pad attenuated the negative inotropic, chronotropic, and dromotropic responses to CVS by 33∼37%. On the other hand, lidocaine, a sodium channel blocker, injected into the SVC-Ao fat pad almost totally inhibited the inotropic and chronotropic responses to CVS and partly inhibited the dromotropic one. Lidocaine or trimethaphan injected into the SAPS locus abolished the inotropic responses to SAPS, but it partly attenuated those to CVS, although these treatments abolished the chronotropic responses to SAPS or CVS. These results suggest that parasympathetic ganglionic cells in the SVC-Ao fat pad, differing from those in SA and AV fat pads, nonselectively control the atrial contractile force, SCL, and AV conduction partially in the dog heart.

scholarly journals Intravenous Leiomyomatosis of the Uterus: A Retrospective Single-Center Study in 14 Cases

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Qingbo Su ◽  
Xiquan Zhang ◽  
Hui Zhang ◽  
Yan Liu ◽  
Zhaoru Dong ◽  
...  
Keyword(s):  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Atrial ◽  
Pelvic Cavity ◽  
Intravenous Leiomyomatosis ◽  
Abdominal Incision ◽  
Imaging Results ◽  
The Right

Purpose. This study aimed to retrospectively review the diagnosis and surgical treatment of uterine intravenous leiomyomatosis (IVL). Methods. The clinical data of 14 patients with uterine IVL admitted to our hospital between 2013 and 2018 were retrospectively analyzed, including their demographics, imaging results, surgical procedures, perioperative complications, and follow-up results. Results. The tumors were confined to the pelvic cavity in 7 patients, 1 into the inferior vena cava, 4 into the right atrium, and 2 into the pulmonary artery (including 1 into the superior vena cava). Only one case was misdiagnosed as right atrial myxoma before the operation, which was found during the surgery and was treated by staging surgery; all the other patients underwent one-stage surgical resection. Three patients underwent complete resection of the right atrial tumor through the abdominal incision, and one patient died of heart failure in the process of resection of heart tumor without abdominal surgery. During the 6–60 months of follow-up, 4 patients developed deep venous thrombosis of the lower extremity, and 1 patient developed ovarian vein thrombosis and pulmonary embolism. After anticoagulation treatment, the symptoms disappeared. One patient refused hysterectomy and the uterine fibroids recurred 4 years after the operation. Conclusion. Specific surgical plans for uterine IVL can be formulated according to cardiac ultrasound and computed tomography (CT). For the first type of tumor involving the right atrium, the right atrium tumor can be completely removed through the abdominal incision alone to avoid thoracotomy. The disease is at high risk of thrombosis and perioperative routine anticoagulation is required.

1207Pulsed Field Ablation: Acute and Chronic Safety and Lesion Efficacy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Verma ◽  
D Haines ◽  
N Kirchhof ◽  
B Onal ◽  
M Martien ◽  
...  
Keyword(s):  
Phrenic Nerve ◽  
Cardiac Tissue ◽  
Superior Vena ◽  
Vena Cava ◽  
Preclinical Study ◽  
Atrial Appendage ◽  
Right Atrial ◽  
Collateral Damage ◽  
Cardiac Tissues ◽  
Electrical Isolation

Abstract Introduction Thermal ablation methods are the cornerstone of treatment for atrial fibrillation. However, they pose a risk to extra-cardiac structures and may result in inadequate efficacy. Nonthermal, pulsed-field ablation (PFA) delivery to cardiac tissues may create durable, efficacious lesions while avoiding collateral damage. Purpose The purpose of this preclinical GLP study was to assess acute and chronic electrical isolation combined with a pathology assessment of chronic lesion extent in response to PFA delivery to cardiac tissue, and to document any collateral damage. Methods Six pigs were treated with biphasic, bipolar PFA doses through a circular multi-electrode catheter. PFA was delivered at four locations at specified voltages: superior vena cava (SVC at 700V), right atrial appendage (RAA at 1500V), left atrial appendage (LAA at 1200V), and right pulmonary vein (RPV at 1500V). Phrenic nerve pacing thresholds and electrical block at SVC, RPV, and RAA sites were investigated acutely, and electrical block at the SVC sites chronically. Pigs were survived for 4 weeks. After euthanasia, necropsies and histopathological assessments documented the findings at the lesion sites and collateral tissues. Results Post PFA, entrance block was achieved in all SVC, RPV, and RAA sites. Histopathology showed characteristic replacement fibrosis of the myocardium at all ablation sites. The PFA lesions in the SVC and RPV were all continuously circumferential and histopathology did not detect any remaining myofiber conduits across the post-ablation fibrosis (consistent with the electrical assessments). PFA of the appendages caused wide-ranging fibrosis in the RAA, and limited fibrosis in the LAA. Histologically, the atrial fibrosis was almost exclusively transmural in both, with the RAA lesions overall diagnosed as circumferentially complete in all but one case. The right phrenic nerve (RPN) pacing thresholds were unchanged from baseline to the end of the procedure and were all <1.0V. The examined juxtaposed RPN segments exposed to PFA at the SVC and RPV sites were normal. None of the ablated targets was associated with stenosis, aneurysms, luminal thrombus or collateral damage on the abluminal side. Continuous lesion sites Conclusions This limited preclinical study evaluated the acute and chronic safety and efficacy of PFA in multiple cardiac and vascular treatment sites. In this porcine model, PFA results in acute and chronic electrical isolation, confirmed by pathology data, for all of the RPV and SVC targets. Pathology findings of the RAA revealed the ability to achieve chronic transmural lesions in highly trabeculated cardiac tissue. No collateral damage was seen to the adjacent RPN. Acknowledgement/Funding Medtronic

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