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High-resolution Optical Mapping of the Mouse Sino-atrial Node
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Insights from preclinical ultra high-density electroanatomical sinus node mapping.

Andreas Bollmann1, Sebastian Hilbert2, Silke John2

  • 1Department of Electrophysiology, Heart Center, Leipzig, Strümpellstr. 39, Leipzig 04289, Germany rhythmo@med.uni-leipzig.de.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|October 29, 2014
PubMed
Summary

Ultra high-density mapping accurately details sinus node activation in pigs, revealing consistent earliest activation sites and sinus break-out patterns. This technology offers potential for improved catheter ablation strategies for sinus node diseases.

Keywords:
Cardiac mappingCatheter ablationSinus node

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Area of Science:

  • Cardiovascular Electrophysiology
  • Cardiac Anatomy and Physiology

Background:

  • Catheter ablation is established for inappropriate sinus tachycardia, but sinus node anatomy and function require further elucidation.
  • Limited electroanatomical mapping data exists for the sinus node, hindering precise ablation strategies.

Purpose of the Study:

  • To assess sinus node activation using an ultra-high-resolution mapping system in a preclinical model.
  • To compare preclinical findings with existing human and animal sinus node mapping studies.
  • To discuss potential clinical implications for catheter ablation of sinus node disorders.

Main Methods:

  • Generated 30 endocardial and 2 epicardial right atrial (RA) maps in 14 pigs using the Rhythmia™ mapping system.
  • Determined earliest activation sites (EAS) and sinus break-out (SBO) at baseline and after pharmacological interventions.
  • Performed sequential endocardial and epicardial mapping to assess congruence of sinus node activation.

Main Results:

  • EAS and SBO were consistently located anterior to the crista terminalis, exhibiting unicentric activation patterns.
  • Significant inter-individual variation was observed in conduction pathway direction, distance, and time.
  • Pharmacological agents induced variable shifts in endocardial activation, with multicentric activation noted in one instance.

Conclusions:

  • Ultra-high-density mapping provides a fast, simple, and detailed assessment of sinus node activation.
  • Further research is necessary to develop novel mapping and ablation strategies for improved sinus node disease management.
  • High congruence was observed between endocardial and epicardial sinus node activation maps.