Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Prevention and Reversal of Atrial Fibrillation Inducibility.

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Basic Mechanisms of Atrial Fibrillation Relative to Ablation Osama Diab MD, Cardiology Lecturer of Cardiology, Ain Shams Universitry-Cairo Consultant Electrophysiologist,
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Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Prevention and Reversal of Atrial Fibrillation Inducibility and Autonomic Remodeling by Low-Level Vagosympathetic Nerve Stimulation J Am Coll Cardiol. 2011;57(5): doi: /j.jacc Schematic Representation of the Right and Left Thoracotomy Approach and Catheter Positions in the Atria and PVs (A) Right thoracotomy. Multielectrode catheters were sutured to the epicardial surface of right atrial appendage (RAA), right atrial free wall (RA), and to the adjacent right superior (RSPV) and right inferior (RIPV) pulmonary veins (PVs). For Group 4 experiments, a plastic barrier was used to isolate the RAA from the rest of the atrium. (B) Left thoracotomy. Similarly, multielectrode catheters were positioned at the left superior PV (LSPV), left inferior PV (LIPV), left atrium (LA), and left atrial appendage (LAA). Rapid atrial pacing (1,200 beats/min) was applied at the LAA. IVC = inferior vena cava; LOM = ligament of Marshall; SVC = superior vena cava. Figure Legend:

Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Prevention and Reversal of Atrial Fibrillation Inducibility and Autonomic Remodeling by Low-Level Vagosympathetic Nerve Stimulation J Am Coll Cardiol. 2011;57(5): doi: /j.jacc Change of Mean ERP at Different Recording Sites During 6-h RAP Accompanied by LL-VNS in the Last 3 h (Group 1, n = 7) *p < 0.05 and **p < 0.01 compared with baseline using paired t test; ▵ p < 0.05, ▵▵ p< 0.01, and ▵▵▵ p < compared with the end of the 3rd hour of rapid atrial pacing (RAP) using paired t test. ERP = effective refractory period; LL-VNS = low-level vagosympathetic nerve stimulation; other abbreviations as in Figure 1. Figure Legend:

Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Prevention and Reversal of Atrial Fibrillation Inducibility and Autonomic Remodeling by Low-Level Vagosympathetic Nerve Stimulation J Am Coll Cardiol. 2011;57(5): doi: /j.jacc Change in Mean ERP at Different Recording Sites During 6-h RAP and Concomitant 6-h LL-VNS (Group 2, n = 4) When RAP and LL-VNS were applied concomitantly, the ERP was not altered throughout the 6-h period. Abbreviations as in Figures 1 and 2. Figure Legend:

Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Prevention and Reversal of Atrial Fibrillation Inducibility and Autonomic Remodeling by Low-Level Vagosympathetic Nerve Stimulation J Am Coll Cardiol. 2011;57(5): doi: /j.jacc Change of ΣWOV and ERP Dispersion During 6-h RAP Cumulative WOV (ΣWOV) (A) and ERP dispersion (C) were increased by 3-h RAP but were reversed by LL-VNS. In contrast, ΣWOV (B) and ERP dispersion (D) were not altered if LL-VNS and RAP were applied concomitantly. All symbols for p values as in Figure 2. Abbreviations as in Figures 1 and 2. Figure Legend:

Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Prevention and Reversal of Atrial Fibrillation Inducibility and Autonomic Remodeling by Low-Level Vagosympathetic Nerve Stimulation J Am Coll Cardiol. 2011;57(5): doi: /j.jacc Comparison Between Groups 1 and 2 **p < 0.01 and ***p < Abbreviations as in Figures 1 and 2. Figure Legend:

Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Prevention and Reversal of Atrial Fibrillation Inducibility and Autonomic Remodeling by Low-Level Vagosympathetic Nerve Stimulation J Am Coll Cardiol. 2011;57(5): doi: /j.jacc Changes of AF Duration and Cycle Length by 3-h LL-VNS (A to D) Group 3. (E to H) Group 4. (*p < 0.05; **p < 0.01; ***p < ). See text for details. AF = atrial fibrillation; CL = cycle length; LL-VNS = low-level vagosympathetic nerve stimulation. Figure Legend:

Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Prevention and Reversal of Atrial Fibrillation Inducibility and Autonomic Remodeling by Low-Level Vagosympathetic Nerve Stimulation J Am Coll Cardiol. 2011;57(5): doi: /j.jacc Comparison Between LL-VNS and No LL-VNS (Sham) Among Group 3 and 4 Animals **p < 0.01 and ***p < 0.001, compared with baseline. ##p < 0.01 and ###p < 0.001, compared with no low-level vagosympathetic nerve stimulation (LL-VNS). Figure Legend: