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Atrial Fat Pad

Andreia Fernandes, Francisca Caetano, Inês Almeida, Luís Paiva, Pedro Gomes, Paula Mota, Joana Trigo, Ana Botelho, Maria do Carmo Cachulo, Joana Alves, Luís Francisco, António Leitão Marques
The authors present a case of systemic amyloidosis with cardiac involvement. We discuss the need for a high level of suspicion to establish a diagnosis, diagnostic techniques and treatment options. Our patient was a 78-year-old man with chronic renal disease and atrial fibrillation admitted with acute decompensated heart failure of unknown cause. The transthoracic echocardiogram revealed severely impaired left ventricular function with phenotypic overlap between hypertrophic and restrictive cardiomyopathy. After an extensive diagnostic workup, which included an abdominal fat pad biopsy, the final diagnosis was amyloidosis...
May 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Evgeny Pokushalov, Boris Kozlov, Alexander Romanov, Artem Strelnikov, Sevda Bayramova, David Sergeevichev, Alexander Bogachev-Prokophiev, Sergey Zheleznev, Vladimir Shipulin, Vladimir V Lomivorotov, Alexander Karaskov, Sunny S Po, Jonathan S Steinberg
BACKGROUND: Animal models suggest that the neurotransmitter inhibitor, botulinum toxin, when injected into the epicardial fat pads can suppress atrial fibrillation inducibility. The aim of this prospective randomized double-blind study was to compare the efficacy and safety of botulinum toxin injection into epicardial fat pads for preventing atrial tachyarrhythmias. METHODS AND RESULTS: Patients with history of paroxysmal atrial fibrillation and indication for coronary artery bypass graft surgery were randomized to botulinum toxin (Xeomin, Merz, Germany; 50 U/1 mL at each fat pad; n=30) or placebo (0...
December 2015: Circulation. Arrhythmia and Electrophysiology
Shanxin Liu, Yunyan Jing, Juhong Zhang, Chang Bian, Y U Zhang, Xingwei Zhang
BACKGROUND: Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). Several prospective randomized controlled trials (RCTs) have evaluated the effect of intact and removed anterior fat pads on the incidence of AF after CABG with conflicting results. We collected these RCTs and conducted a meta-analysis to determine whether anterior fat pad removal is effective in preventing the new onset of AF after CABG. METHODS AND RESULTS: Prospective RCTs were collected for analysis and the main outcomes include the occurrence of AF after CABG, total hospital stay, and major complications...
November 2015: Pacing and Clinical Electrophysiology: PACE
Yujiao Zhang, Shaohua Zheng, Yangyang Geng, Jiao Xue, Zhongsu Wang, Xinxing Xie, Jiangrong Wang, Shuyu Zhang, Yinglong Hou
BACKGROUND: A critical mechanism in atrial fibrillation (AF) is cardiac autonomic nerve remodeling (ANR). MicroRNAs (miRNAs) are small non-coding RNAs that regulate gene expression at the post-transcriptional level. Numerous miRNAs are involved in diseases of the nervous and cardiovascular systems. OBJECTIVE: We aimed to assess the underlying role of miRNAs in regulating cardiac ANR in AF by right atrial tachypacing (A-TP) in canines. METHODS AND RESULTS: Following 4-week A-TP, the superior left ganglionated plexuses (SLGPs), which are embedded in the fat pads of the left atrium, were subjected to miRNA expression profiling to screen preferentially expressed miRNAs...
2015: PloS One
Yutao Xi, Zhi-Yang James Chao, Wen Yan, Shahrzad Abbasi, Xiaomeng Yin, Nilesh Mathuria, Mehul Patel, Christopher Fan, Junping Sun, Geru Wu, Suwei Wang, MacArthur Elayda, Lianjun Gao, Xander H T Wehrens, Shien-Fong Lin, Jie Cheng
BACKGROUND: Vagal hyperactivity promotes atrial fibrillation (AF), which has been almost exclusively attributed to acetylcholine. Vasoactive intestinal polypeptide (VIP) and acetylcholine are neurotransmitters co-released during vagal stimulation. Exogenous VIP has been shown to promote AF by shortening action potential duration (APD), increasing APD spatial heterogeneity, and causing intra-atrial conduction block. OBJECTIVE: The purpose of this study was to investigate the effects of neuronally released VIP on atrial electrophysiologic properties during vagal stimulation...
June 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Weizong Wang, Ximin Wang, Yujiao Zhang, Zhan Li, Xinxing Xie, Jiangrong Wang, Mei Gao, Shuyu Zhang, Yinglong Hou
Intrinsic cardiac autonomic neural remodeling (ANR) has been reported to be involved in the initiation and maintenance of atrial fibrillation (AF). Long non-coding RNAs (lncRNAs) are important orchestrators of gene regulatory networks. However, little is known about the relationships between lncRNAs and cardiac ANR in AF. In this study, second-generation RNA sequencing was performed to examine the transcriptomes of lncRNAs in AF and non-AF canine cardiac fat pads. A total of 61,616 putative lncRNAs were yielded, in which 166 were downregulated and 410 were upregulated with more than twofold change...
May 2015: Journal of Cellular Biochemistry
Yang Yu, Cao Wei, Li Liu, Ai Ling Lian, Xiu Fen Qu, Guang Yu
BACKGROUND: Chronic atrial fibrillation (AF) leads to heterogeneous autonomic nerve innervation termed neural remodeling. The quantitative changes in neural density as a function of autonomic remodeling and its association with sustained AF has not been previously determined. METHOD AND RESULTS: Seven dogs (paced group) were chronically paced with electrodes sutured to the epicardium of left atrial appendages. Seven dogs (control animals) were not paced. All paced dogs developed sustained AF by 5 weeks of pacing...
November 2014: Pacing and Clinical Electrophysiology: PACE
Sameer Chadha, On Chen, Sunday Olatunde, Adnan Sadiq, Gerald Hollander, Jacob Shani
SESSION TITLE: Rare Disease Case Report PostersSESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Amyloid Cardiomyopathy is characterized by bi-ventricular thickening due to amyloid deposition leading to diastolic dysfunction. CASE PRESENTATION: A 73 year old female with no past medical history presented to our emergency department (ED) with gradually worsening shortness of breath for few weeks. She denied any associated complaints of chest pain, palpitations or dizziness...
March 1, 2014: Chest
G Iacobellis, M C Zaki, D Garcia, H J Willens
Obesity is a well-known risk factor for atrial fibrillation (AF) and heart failure (HF). Epicardial fat, the true visceral fat depot of the heart, has been associated with changes in both cardiac function and morphology. In this study, we evaluated whether ultrasound-measured epicardial fat thickness is related to AF and HF. A cross-sectional study was performed in 84 consecutive subjects with clinical and ECG-documented history of permanent (AF) or paroxysmal AF (PAF) who underwent echocardiographic epicardial fat thickness measurement...
July 2014: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Qina Zhou, Ling Zhang, Kun Wang, Xiaoxia Xu, Meng Ji, Feng Zhang, Hongli Wang, Yuemei Hou
BACKGROUND: The epicardial fat pad (FP) integrates the autonomic innervation between the extrinsic and intrinsic cardiac autonomic nervous system and affects atrial electrophysiology and pathophysiology. METHODS: Eighteen dogs were divided into two groups: sequential ablation of sinoatrial node FP (SAN-FP) and atrioventricular node FP (AVN-FP). Sinus rate (SR), atrial fibrillation (AF) inducibility, and effective refractory period (ERP) changes during electrical stimulation of the vagus trunk were detected before and after ablation...
March 2014: Pacing and Clinical Electrophysiology: PACE
Jeffrey P Moak, Marco A Mercader, Dingchao He, Gregory Trachiotis, Joshua Langert, Andy Blicharz, Erin Montaque, Xiyan Li, Yao I Cheng, Robert McCarter, Gene A Bornzin, Gerard R Martin, Richard A Jonas
BACKGROUND: Supraventricular arrhythmias (junctional ectopic tachycardia [JET] and atrial tachyarrhythmias) frequently complicate recovery from open heart surgery in children and can be difficult to manage. Medical treatment of JET can result in significant morbidity. Our goal was to develop a nonpharmacological approach using autonomic stimulation of selective fat pad (FP) regions of the heart in a young canine model of open heart surgery to control 2 common postoperative supraventricular arrhythmias...
June 2013: Circulation. Arrhythmia and Electrophysiology
Koji Higuchi, Mehmet Akkaya, Matthias Koopmann, Joshua J E Blauer, Nathan S Burgon, Kavitha Damal, Ravi Ranjan, Eugene Kholmovski, Rob S Macleod, Nassir F Marrouche
BACKGROUND: Magnetic resonance imaging (MRI) can visualize locations of both the ablation scar on the left atrium (LA) after atrial fibrillation (AF) ablation and epicardial fat pads (FPs) containing ganglionated plexi (GP). METHODS: We investigated 60 patients who underwent pulmonary vein antrum (PVA) isolation along with LA posterior wall and septal debulking for AF. FPs around the LA surface in well-known GP areas (which were considered as the substitution of GP areas around the LA) were segmented from the dark-blood MRI...
April 2013: Pacing and Clinical Electrophysiology: PACE
Majid Haghjoo
Atrial fibrillation (AF) is the most common complication of coronary artery bypass graft surgery (CABG). The reported incidence of AF after CABG varies from 20% to 40%. Postoperative AF (POAF) is associated with increased incidence of hemodynamic instability, thromboembolic events, longer hospital stays, and increased health care costs. A variety of pharmacological and nonpharmacological strategies have been employed to prevent AF after CABG. Preoperative and postoperative beta blockers are recommended in all cardiac surgery patients as the first-line medication to prevent POAF...
2012: Journal of Tehran Heart Center
Michael E Field, Mohamed H Hamdan
No abstract text is available yet for this article.
January 2013: Journal of Cardiovascular Electrophysiology
Italo Martins de Oliveira, Bárbara Daniela Oliveira, Maurício Ibrahim Scanavacca, Paulo Sampaio Gutierrez
Atrial myocardium fibrosis and other alterations of fiber continuity and potential circuit reentrancy (disconnections, abrupt turns, crossings, and epicardial reflections) are thought to play an important role in permanent atrial fibrillation. However, few studies have been performed in human beings. Some of them are only descriptive, and controls were usually normal hearts; thus, differences between cases and controls could be related to the underlying disease rather than the arrhythmia. We quantified by histomorphometry the above characteristics in nine samples (three from the left atrium, three from around fat pads, one from the right atrium, one from the cavum-tricuspid isthmus, and one from the ventricular septum) from 13 necropsy hearts of patients with permanent atrial fibrillation and compared the findings with those from 13 control cases with the same diseases but without any atrial arrhythmia...
January 2013: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Youhua Zhang, Zoran B Popović, Kenya Kusunose, Todor N Mazgalev
INTRODUCTION: Atrial fibrillation (AF) and heart failure (HF) frequently coexist. We have previously demonstrated that selective atrioventricular node (AVN) vagal stimulation (AVN-VS) can be used to control ventricular rate during AF. Due to withdrawal of vagal activity in HF, the therapeutic effects of AVN-VS may be compromised in the combined condition of AF and HF. Accordingly, this study was designed to evaluate the therapeutic effects of AVN-VS to control ventricular rate in AF and HF...
January 2013: Journal of Cardiovascular Electrophysiology
Sen Lei, Pi-hua Fang, Jun Liu, Yu Hou
OBJECTIVE: The objective of this study was to investigate the effect of selective fat pad ablation on the spatial and temporal stability of the complex fractionated atrial electrogram (CFAE) in acetylcholine (ACh)-induced atrial fibrillation (AF). METHODS AND RESULTS: ACh was applied to fat pads in 10 dogs. Effective refractory periods (ERPs) at 5 different sites, AF inducibility and AF duration were obtained before and after fat pad ablation. During the first two induced AFs, the number of sites with continuous CFAEs and the duration of continuous CFAEs at every site were measured before and after fat pad ablation...
February 2012: Acta Cardiologica
Husam H Balkhy, John Hare, Haris J Sih
OBJECTIVE: : Autonomic ganglionated plexi (GP) in fat pads near the pulmonary veins may contribute to initiation and maintenance atrial fibrillation (AF). We attempted to localize these plexi in a canine model, and evaluate the efficacy of microwave ablation in eliminating their vagal reflexes. METHODS: : 8 Mongrel dogs (25-31 kg), underwent cervical vagal trunk stimulation to produce AV nodal block and sustained AF. Sternotomy was performed and the epicardial fat on the posterior left atrium and pulmonary veins was locally stimulated at high-frequency (20 Hz, 3-5 mA)...
January 2007: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Konstantinos Chryssagis, Stefan Klügl, Aris Liangos, Klaus J Gutleben, Johannes Brachmann, Anno Diegeler
OBJECTIVE: : Atrial fibrillation (AF) is the most common complication following coronary artery bypass grafting or valve surgery.The autonomic nervous system is an important determinant in the development of AF. We have assessed the role of injection of fibrin sealant (FS) as a method to modify conduction in the fad pads, to mimic temporary denervation and to reduce the incidence of postoperative AF in patients undergoing coronary artery bypass grafting or valve surgery. PATIENTS AND METHODS: : Twenty eligible patients who underwent coronary bypass grafting or aortic valve surgery in our Institution were included in this pilot - study...
May 2008: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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