Electrophysiological Characteristics of Arterially-Perfused Canine Pulmonary Veins: Role of the Delayed Afterdepolarization-Induced Triggered Activity

Background and Objectives:The mechanism responsible for the generation of ectopic beats in pulmonary veins (PVs) remains to be well defined. The present study examines the electrophysiological characteristics of the PVs and other regions of the canine left atrium (LA) under low dose (300 μM) caffeine condition. Materials and Methods:Transmembrane action potentials were recorded from the left superior PVs, PV-LA junctions (PLJ, atrium <5 mm from the PV ostium), LA appendage (LAA) or Bachmann’s bundle (BB) in arterially perfused canine LA-PV preparations, using floating glass microelectrodes. Rapid atrial pacing (cycle lengths 140-300 ms, 10 sec) was used to induce delayed afterdepolarizations (DAD) at the baseline and under low dose (300 μM) caffeine conditions. Results:Spontaneous diastolic depolarization or triggered activity (TA) was not observed in any of the recording area under the baseline condition. DAD and TA were induced by caffeine in 4/8 PVs and in 3/8 PLJs, but in no LAA (0/6) or BB (0/5). These TA and DAD were also observed after termination of pacing-induced atrial tachyarrhythmia. DAD was abolished by pretreatment of the atria with verapamil or propranolol (1.0 μM). Conclusion:Spontaneous diastolic depolarization was not present in perfused canine left atria or proximal PV. Pulmonary veins and adjacent areas displayed an increased susceptibility to develop DAD-induced TA under low dose caffeine condition. This distinctive electrophysiological property of the PV and PLJ area may contribute to the arrhythmogenic substrate responsible for the ectopic activity that initiates atrial fibrillation. (Korean Circulation J 2005;35:643-648)