Structural and electro-anatomical characterization of the equine pulmonary veins: implications for atrial fibrillation

S T Kjeldsen; S D Nissen; A Saljic; E M Hesselkilde; H Carstensen; S M Sattler; T Jespersen; D Linz; C Hopster-Iversen; R Kutieleh; P Sanders; R Buhl

doi:10.1016/j.jvc.2024.01.001

Structural and electro-anatomical characterization of the equine pulmonary veins: implications for atrial fibrillation

S T Kjeldsen, S D Nissen, A Saljic, E M Hesselkilde, H Carstensen, S M Sattler, T Jespersen, D Linz, C Hopster-Iversen, R Kutieleh, P Sanders, R Buhl

Abstract

INTRODUCTION/OBJECTIVES: Spontaneous pulmonary vein (PV) activity triggers atrial fibrillation (AF) in humans. Although AF frequently occurs in horses, the origin remains unknown. This study investigated the structural and electro-anatomical properties of equine PVs to determine the potential presence of an arrhythmogenic substrate.

ANIMALS, MATERIALS AND METHODS: Endocardial three-dimensional electro-anatomical mapping (EnSite Precision) using high-density (HD) catheters was performed in 13 sedated horses in sinus rhythm. Left atrium (LA) access was obtained retrogradely through the carotid artery. Post-mortem, tissue was harvested from the LA, right atrium (RA), and PVs for histological characterization and quantification of ion channel expression using immunohistochemical analysis.

RESULTS: Geometry, activation maps, and voltage maps of the PVs were created and a median of four ostia were identified. Areas of reduced conduction were found at the veno-atrial junction. The mean myocardial sleeve length varied from 28 ± 13 to 49 ± 22 mm. The PV voltage was 1.2 ± 1.4 mV and lower than the LA (3.4 ± 0.9 mV, P < 0.001). The fibrosis percentage was higher in PV myocardium (26.1 ± 6.6 %) than LA (14.5 ± 5.0 %, P = 0.003). L-type calcium channel (CaV1.2) expression was higher in PVs than LA (P = 0.001). T-type calcium channels (CaV3.3), connexin-43, ryanodine receptor-2, and small conductance calcium-activated potassium channel-3 was expressed in PVs.

CONCLUSIONS: The veno-atrial junction had lower voltages, increased structural heterogeneity and areas of slower conduction. Myocardial sleeves had variable lengths, and a different ion channel expression compared to the atria. Heterogeneous properties of the PVs interacting with the adjacent LA likely provide the milieu for re-entry and AF initiation.

Original language	English
Journal	Journal of Veterinary Cardiology
Volume	52
Pages (from-to)	1-13
Number of pages	13
ISSN	1760-2734
DOIs	https://doi.org/10.1016/j.jvc.2024.01.001
Publication status	E-pub ahead of print - 6 Jan 2024

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Kjeldsen, S. T., Nissen, S. D., Saljic, A., Hesselkilde, E. M., Carstensen, H., Sattler, S. M., Jespersen, T., Linz, D., Hopster-Iversen, C., Kutieleh, R., Sanders, P., & Buhl, R. (2024). Structural and electro-anatomical characterization of the equine pulmonary veins: implications for atrial fibrillation. Journal of Veterinary Cardiology, 52, 1-13. Advance online publication. https://doi.org/10.1016/j.jvc.2024.01.001

Kjeldsen, ST, Nissen, SD, Saljic, A, Hesselkilde, EM, Carstensen, H, Sattler, SM , Jespersen, T, Linz, D, Hopster-Iversen, C, Kutieleh, R, Sanders, P & Buhl, R 2024, 'Structural and electro-anatomical characterization of the equine pulmonary veins: implications for atrial fibrillation', Journal of Veterinary Cardiology, vol. 52, pp. 1-13. https://doi.org/10.1016/j.jvc.2024.01.001

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title = "Structural and electro-anatomical characterization of the equine pulmonary veins: implications for atrial fibrillation",

abstract = "INTRODUCTION/OBJECTIVES: Spontaneous pulmonary vein (PV) activity triggers atrial fibrillation (AF) in humans. Although AF frequently occurs in horses, the origin remains unknown. This study investigated the structural and electro-anatomical properties of equine PVs to determine the potential presence of an arrhythmogenic substrate.ANIMALS, MATERIALS AND METHODS: Endocardial three-dimensional electro-anatomical mapping (EnSite Precision) using high-density (HD) catheters was performed in 13 sedated horses in sinus rhythm. Left atrium (LA) access was obtained retrogradely through the carotid artery. Post-mortem, tissue was harvested from the LA, right atrium (RA), and PVs for histological characterization and quantification of ion channel expression using immunohistochemical analysis.RESULTS: Geometry, activation maps, and voltage maps of the PVs were created and a median of four ostia were identified. Areas of reduced conduction were found at the veno-atrial junction. The mean myocardial sleeve length varied from 28 ± 13 to 49 ± 22 mm. The PV voltage was 1.2 ± 1.4 mV and lower than the LA (3.4 ± 0.9 mV, P < 0.001). The fibrosis percentage was higher in PV myocardium (26.1 ± 6.6 %) than LA (14.5 ± 5.0 %, P = 0.003). L-type calcium channel (CaV1.2) expression was higher in PVs than LA (P = 0.001). T-type calcium channels (CaV3.3), connexin-43, ryanodine receptor-2, and small conductance calcium-activated potassium channel-3 was expressed in PVs.CONCLUSIONS: The veno-atrial junction had lower voltages, increased structural heterogeneity and areas of slower conduction. Myocardial sleeves had variable lengths, and a different ion channel expression compared to the atria. Heterogeneous properties of the PVs interacting with the adjacent LA likely provide the milieu for re-entry and AF initiation.",

author = "Kjeldsen, {S T} and Nissen, {S D} and A Saljic and Hesselkilde, {E M} and H Carstensen and Sattler, {S M} and T Jespersen and D Linz and C Hopster-Iversen and R Kutieleh and P Sanders and R Buhl",

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doi = "10.1016/j.jvc.2024.01.001",

language = "English",

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T1 - Structural and electro-anatomical characterization of the equine pulmonary veins

T2 - implications for atrial fibrillation

AU - Kjeldsen, S T

AU - Nissen, S D

AU - Saljic, A

AU - Hesselkilde, E M

AU - Carstensen, H

AU - Sattler, S M

AU - Jespersen, T

AU - Linz, D

AU - Hopster-Iversen, C

AU - Kutieleh, R

AU - Sanders, P

AU - Buhl, R

PY - 2024/1/6

Y1 - 2024/1/6

N2 - INTRODUCTION/OBJECTIVES: Spontaneous pulmonary vein (PV) activity triggers atrial fibrillation (AF) in humans. Although AF frequently occurs in horses, the origin remains unknown. This study investigated the structural and electro-anatomical properties of equine PVs to determine the potential presence of an arrhythmogenic substrate.ANIMALS, MATERIALS AND METHODS: Endocardial three-dimensional electro-anatomical mapping (EnSite Precision) using high-density (HD) catheters was performed in 13 sedated horses in sinus rhythm. Left atrium (LA) access was obtained retrogradely through the carotid artery. Post-mortem, tissue was harvested from the LA, right atrium (RA), and PVs for histological characterization and quantification of ion channel expression using immunohistochemical analysis.RESULTS: Geometry, activation maps, and voltage maps of the PVs were created and a median of four ostia were identified. Areas of reduced conduction were found at the veno-atrial junction. The mean myocardial sleeve length varied from 28 ± 13 to 49 ± 22 mm. The PV voltage was 1.2 ± 1.4 mV and lower than the LA (3.4 ± 0.9 mV, P < 0.001). The fibrosis percentage was higher in PV myocardium (26.1 ± 6.6 %) than LA (14.5 ± 5.0 %, P = 0.003). L-type calcium channel (CaV1.2) expression was higher in PVs than LA (P = 0.001). T-type calcium channels (CaV3.3), connexin-43, ryanodine receptor-2, and small conductance calcium-activated potassium channel-3 was expressed in PVs.CONCLUSIONS: The veno-atrial junction had lower voltages, increased structural heterogeneity and areas of slower conduction. Myocardial sleeves had variable lengths, and a different ion channel expression compared to the atria. Heterogeneous properties of the PVs interacting with the adjacent LA likely provide the milieu for re-entry and AF initiation.

AB - INTRODUCTION/OBJECTIVES: Spontaneous pulmonary vein (PV) activity triggers atrial fibrillation (AF) in humans. Although AF frequently occurs in horses, the origin remains unknown. This study investigated the structural and electro-anatomical properties of equine PVs to determine the potential presence of an arrhythmogenic substrate.ANIMALS, MATERIALS AND METHODS: Endocardial three-dimensional electro-anatomical mapping (EnSite Precision) using high-density (HD) catheters was performed in 13 sedated horses in sinus rhythm. Left atrium (LA) access was obtained retrogradely through the carotid artery. Post-mortem, tissue was harvested from the LA, right atrium (RA), and PVs for histological characterization and quantification of ion channel expression using immunohistochemical analysis.RESULTS: Geometry, activation maps, and voltage maps of the PVs were created and a median of four ostia were identified. Areas of reduced conduction were found at the veno-atrial junction. The mean myocardial sleeve length varied from 28 ± 13 to 49 ± 22 mm. The PV voltage was 1.2 ± 1.4 mV and lower than the LA (3.4 ± 0.9 mV, P < 0.001). The fibrosis percentage was higher in PV myocardium (26.1 ± 6.6 %) than LA (14.5 ± 5.0 %, P = 0.003). L-type calcium channel (CaV1.2) expression was higher in PVs than LA (P = 0.001). T-type calcium channels (CaV3.3), connexin-43, ryanodine receptor-2, and small conductance calcium-activated potassium channel-3 was expressed in PVs.CONCLUSIONS: The veno-atrial junction had lower voltages, increased structural heterogeneity and areas of slower conduction. Myocardial sleeves had variable lengths, and a different ion channel expression compared to the atria. Heterogeneous properties of the PVs interacting with the adjacent LA likely provide the milieu for re-entry and AF initiation.

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U2 - 10.1016/j.jvc.2024.01.001

DO - 10.1016/j.jvc.2024.01.001

M3 - Journal article

C2 - 38290222

SN - 1760-2734

VL - 52

SP - 1

EP - 13

JO - Journal of Veterinary Cardiology

JF - Journal of Veterinary Cardiology

ER -

Structural and electro-anatomical characterization of the equine pulmonary veins: implications for atrial fibrillation

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