Parasympathetic Tone Selectively Modulates Electrogram Fragmentation and Spectral Properties in Right Atrial...

Area of Science:

• Cardiology
• Electrophysiology
• Autonomic Nervous System

Background:

• Ganglionated plexi (GP) are crucial in cardiac autonomic regulation.
• Electrogram (EGM) fragmentation and spectral analysis are proposed methods for GP identification.
• The relationship between these GP identification methods and their modulation by parasympathetic tone requires further investigation.

Purpose of the Study:

• To investigate the correlation between EGM fragmentation and spectral properties of GP regions.
• To determine if these properties are modulated by parasympathetic tone.
• To explore the implications for cardioneuroablation (CNA).

Main Methods:

• High-density right atrial mapping in 13 patients undergoing electrophysiological studies.
• Spectral analysis using fast Fourier transformation (FFT) to derive mean, median, and skewness.
• Comparison of spectral properties during baseline and post-atropine administration.

Main Results:

• GP regions exhibited fragmented EGMs with higher mean/median frequencies and lower skewness compared to myocardium.
• Atropine administration significantly decreased mean and median frequencies and increased skewness in GP regions.
• No significant spectral alterations were observed in non-GP regions post-atropine.

Conclusions:

• EGM fragmentation and spectral properties are significantly correlated in identifying GP regions.
• Parasympathetic tone selectively modulates these features within GP areas.
• The distinct GP signal characteristics may stem from cholinergic activity and structural properties, aiding precise CNA targeting.