| Description |
Introduction: Gangliar plexi (GP) are bundles of interconnected neurons found embedded in FPs (FPs) surrounding the atria of the heart. The function of these neurons is controversial but they may form a localized control system for the heart and play a role in the induction of atrial fibrillation (AF), the most common form of heart rhythm disturbance. During the treatment of AF, catheters inserted into the heart via the venous system apply radio frequency (RF) energy to sites on the inner surface of the heart in order to disrupt the triggering of AF. In many cases, the sites of ablation overlap the locations of the GP and we hypothesize that the resulting damage to the myocardial tissue adjacent to the GP may contribute to success of the ablation procedure. Methods: To identify the sites of ablation and locations of the FPs containing GP, we acquired late gadolinium enhanced (LGE) MRI scans and dark blood (DB) MRI scans and analyzed them using segmenting software from the SCI Institute at the University of Utah called Seg3D. Regions of enhanced intensity in LGEMRI scans identified the lesion locations, which we segmented to create a mask or template. The DBMRI scans provided locations of the FPs, which we also segmented into six separate locations in each heart. To determine overlap between ablation sites and GP, the LGEMRI and DBMRI images were registered (aligned) and the extent of overlap quantified. Conclusion: The findings do not support the hypothesis in that ablating the myocardial tissue adjacent to the GP in the FPs surrounding the left atrium results in improved success of the ablation procedure for curing AF. The mechanism of initiation and maintenance of AF is still a mystery, but through this study we were able to narrow the search for truth regarding the origin of AF. |
