Reliable pace termination of postoperative atrial fibrillation in the canine sterile pericarditis model: Implications for atypical atrial flutter

• DOI: 10.1016/j.hroo.2022.01.003
• Publication Date: 2022-01-13T22:26:50Z
• Authors: Seungyup Lee; Sergey Vitebskiy; Robert N. Goldstein; Celeen M. Khrestian; Albert L. Waldo
• Keywords: Atrium (architecture)

We have identified a reentrant circuit in the pulmonary vein region, which drives atria, producing fibrillatory conduction, as one mechanism of postoperative atrial fibrillation (POAF) canine sterile pericarditis model.In this model, we tested hypothesis that overdrive pacing from site at or near such would interrupt it and thereby terminate POAF.We studied 11 dogs on days 1-4. Atrial electrograms (AEGs) were recorded during POAF, pacing, pace termination 3 sites simultaneously: Bachmann's bundle, posterior left atrium, right appendage. When AEGs demonstrated regular activation, was attempted by delivering drive train starting with 4 consecutive beats cycle length (CL) 2-5 ms shorter than intrinsic CL.Sixteen episodes sustained POAF (>5 minutes) diagnosed electrocardiogram induced. During all atrium exhibited ie, constant AEG morphology CL. capture occurred (mean 13 ± 5, range 5-23 beats), 16 successfully terminated. In episodes, end but prior to return sinus rhythm, there disorganized activation previously organized 2 seconds, 0.1-8 seconds). However, these did not sustain absence ("driver").Overdrive demonstrating terminated interrupting circuit.