Spontaneous atrial flutter in a chronic canine model of the modified fontan operation

Sanjiv K. Gandhi, Burt I. Bromberg, Mark D. Rodefeld, Richard B. Schuessler, John P. Boineau, James L. Cox, Charles B. Huddleston

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives. This study sought to 1) establish whether the atrial flutter (AFL) inducible acutely occurs spontaneously in a chronic canine model, and 2) characterize any reentrant circuits present chronically. Background. We previously demonstrated, in an acute canine model of the modified Fontan operation, that the lateral tunnel suture line creates a sufficient electrophysiologic substrate for AFL. Methods. Using cardiopulmonary bypass, a suture line was placed through a right atriotomy in adult dogs (n = 7) to simulate the lateral tunnel of the Fontan operation. Holter recordings were made preoperatively, on the first postoperative day and 2, 4 and 6 weeks postoperatively. At 6 to 8 weeks, through bilateral ventriculotomies, 253- point unipolar atrial electrodes were inserted. AFL was induced using atrial burst pacing, and endocardial activation sequence maps were created. Results. Preoperatively, all dogs were in sinus rhythm. Spontaneous AFL occurred in all dogs postoperatively, with a mean (±SD) cycle length of 192 ± 22 ms. At 6 weeks postoperatively, of six dogs that survived, four had intermittent AFL, and two had incessant AFL. At reoperation, sustained AFL was inducible in six of six dogs, with a mean cycle length of 194 ± 17 ms. Activation sequence maps demonstrated conduction block at the lateral tunnel suture line, which facilitated unidirectional conduction critical for propagation of the reentrant circuit. The AFL circuit was similar to that observed acutely. Conclusions. In a chronic canine model of the modified Fontan operation, the lateral tunnel suture line alone, in the absence of atrial stretch or hypertension, provides an electrophysiologic substrate that promotes spontaneous AFL. This model may be useful for evaluating various forms of treatment and prevention of AFL after the Fontan operation.

Original languageEnglish (US)
Pages (from-to)1095-1103
Number of pages9
JournalJournal of the American College of Cardiology
Volume30
Issue number4
DOIs
StatePublished - Oct 1 1997

Fingerprint

Fontan Procedure
Atrial Flutter
Canidae
Sutures
Dogs
Cardiopulmonary Bypass
Reoperation
Electrodes
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Gandhi, S. K., Bromberg, B. I., Rodefeld, M. D., Schuessler, R. B., Boineau, J. P., Cox, J. L., & Huddleston, C. B. (1997). Spontaneous atrial flutter in a chronic canine model of the modified fontan operation. Journal of the American College of Cardiology, 30(4), 1095-1103. https://doi.org/10.1016/S0735-1097(97)00263-5

Spontaneous atrial flutter in a chronic canine model of the modified fontan operation. / Gandhi, Sanjiv K.; Bromberg, Burt I.; Rodefeld, Mark D.; Schuessler, Richard B.; Boineau, John P.; Cox, James L.; Huddleston, Charles B.

In: Journal of the American College of Cardiology, Vol. 30, No. 4, 01.10.1997, p. 1095-1103.

Research output: Contribution to journalArticle

Gandhi, Sanjiv K. ; Bromberg, Burt I. ; Rodefeld, Mark D. ; Schuessler, Richard B. ; Boineau, John P. ; Cox, James L. ; Huddleston, Charles B. / Spontaneous atrial flutter in a chronic canine model of the modified fontan operation. In: Journal of the American College of Cardiology. 1997 ; Vol. 30, No. 4. pp. 1095-1103.
@article{b45ceb59c5b14b1297d18c53d63d23d0,
title = "Spontaneous atrial flutter in a chronic canine model of the modified fontan operation",
abstract = "Objectives. This study sought to 1) establish whether the atrial flutter (AFL) inducible acutely occurs spontaneously in a chronic canine model, and 2) characterize any reentrant circuits present chronically. Background. We previously demonstrated, in an acute canine model of the modified Fontan operation, that the lateral tunnel suture line creates a sufficient electrophysiologic substrate for AFL. Methods. Using cardiopulmonary bypass, a suture line was placed through a right atriotomy in adult dogs (n = 7) to simulate the lateral tunnel of the Fontan operation. Holter recordings were made preoperatively, on the first postoperative day and 2, 4 and 6 weeks postoperatively. At 6 to 8 weeks, through bilateral ventriculotomies, 253- point unipolar atrial electrodes were inserted. AFL was induced using atrial burst pacing, and endocardial activation sequence maps were created. Results. Preoperatively, all dogs were in sinus rhythm. Spontaneous AFL occurred in all dogs postoperatively, with a mean (±SD) cycle length of 192 ± 22 ms. At 6 weeks postoperatively, of six dogs that survived, four had intermittent AFL, and two had incessant AFL. At reoperation, sustained AFL was inducible in six of six dogs, with a mean cycle length of 194 ± 17 ms. Activation sequence maps demonstrated conduction block at the lateral tunnel suture line, which facilitated unidirectional conduction critical for propagation of the reentrant circuit. The AFL circuit was similar to that observed acutely. Conclusions. In a chronic canine model of the modified Fontan operation, the lateral tunnel suture line alone, in the absence of atrial stretch or hypertension, provides an electrophysiologic substrate that promotes spontaneous AFL. This model may be useful for evaluating various forms of treatment and prevention of AFL after the Fontan operation.",
author = "Gandhi, {Sanjiv K.} and Bromberg, {Burt I.} and Rodefeld, {Mark D.} and Schuessler, {Richard B.} and Boineau, {John P.} and Cox, {James L.} and Huddleston, {Charles B.}",
year = "1997",
month = "10",
day = "1",
doi = "10.1016/S0735-1097(97)00263-5",
language = "English (US)",
volume = "30",
pages = "1095--1103",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Spontaneous atrial flutter in a chronic canine model of the modified fontan operation

AU - Gandhi, Sanjiv K.

AU - Bromberg, Burt I.

AU - Rodefeld, Mark D.

AU - Schuessler, Richard B.

AU - Boineau, John P.

AU - Cox, James L.

AU - Huddleston, Charles B.

PY - 1997/10/1

Y1 - 1997/10/1

N2 - Objectives. This study sought to 1) establish whether the atrial flutter (AFL) inducible acutely occurs spontaneously in a chronic canine model, and 2) characterize any reentrant circuits present chronically. Background. We previously demonstrated, in an acute canine model of the modified Fontan operation, that the lateral tunnel suture line creates a sufficient electrophysiologic substrate for AFL. Methods. Using cardiopulmonary bypass, a suture line was placed through a right atriotomy in adult dogs (n = 7) to simulate the lateral tunnel of the Fontan operation. Holter recordings were made preoperatively, on the first postoperative day and 2, 4 and 6 weeks postoperatively. At 6 to 8 weeks, through bilateral ventriculotomies, 253- point unipolar atrial electrodes were inserted. AFL was induced using atrial burst pacing, and endocardial activation sequence maps were created. Results. Preoperatively, all dogs were in sinus rhythm. Spontaneous AFL occurred in all dogs postoperatively, with a mean (±SD) cycle length of 192 ± 22 ms. At 6 weeks postoperatively, of six dogs that survived, four had intermittent AFL, and two had incessant AFL. At reoperation, sustained AFL was inducible in six of six dogs, with a mean cycle length of 194 ± 17 ms. Activation sequence maps demonstrated conduction block at the lateral tunnel suture line, which facilitated unidirectional conduction critical for propagation of the reentrant circuit. The AFL circuit was similar to that observed acutely. Conclusions. In a chronic canine model of the modified Fontan operation, the lateral tunnel suture line alone, in the absence of atrial stretch or hypertension, provides an electrophysiologic substrate that promotes spontaneous AFL. This model may be useful for evaluating various forms of treatment and prevention of AFL after the Fontan operation.

AB - Objectives. This study sought to 1) establish whether the atrial flutter (AFL) inducible acutely occurs spontaneously in a chronic canine model, and 2) characterize any reentrant circuits present chronically. Background. We previously demonstrated, in an acute canine model of the modified Fontan operation, that the lateral tunnel suture line creates a sufficient electrophysiologic substrate for AFL. Methods. Using cardiopulmonary bypass, a suture line was placed through a right atriotomy in adult dogs (n = 7) to simulate the lateral tunnel of the Fontan operation. Holter recordings were made preoperatively, on the first postoperative day and 2, 4 and 6 weeks postoperatively. At 6 to 8 weeks, through bilateral ventriculotomies, 253- point unipolar atrial electrodes were inserted. AFL was induced using atrial burst pacing, and endocardial activation sequence maps were created. Results. Preoperatively, all dogs were in sinus rhythm. Spontaneous AFL occurred in all dogs postoperatively, with a mean (±SD) cycle length of 192 ± 22 ms. At 6 weeks postoperatively, of six dogs that survived, four had intermittent AFL, and two had incessant AFL. At reoperation, sustained AFL was inducible in six of six dogs, with a mean cycle length of 194 ± 17 ms. Activation sequence maps demonstrated conduction block at the lateral tunnel suture line, which facilitated unidirectional conduction critical for propagation of the reentrant circuit. The AFL circuit was similar to that observed acutely. Conclusions. In a chronic canine model of the modified Fontan operation, the lateral tunnel suture line alone, in the absence of atrial stretch or hypertension, provides an electrophysiologic substrate that promotes spontaneous AFL. This model may be useful for evaluating various forms of treatment and prevention of AFL after the Fontan operation.

UR - http://www.scopus.com/inward/record.url?scp=0030770796&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030770796&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(97)00263-5

DO - 10.1016/S0735-1097(97)00263-5

M3 - Article

C2 - 9316545

AN - SCOPUS:0030770796

VL - 30

SP - 1095

EP - 1103

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 4

ER -