Frequency-dependent electrophysiological properties of concealed slow pathway of isolated rabbit atrioventricular node preparation after fast pathway ablation in a functional model

Introduction: Intranodal pathways of atrioventricular (AV) node play a vital role in the delay of conduction time in response to various atrial inputs. The present study was aimed to determine the frequency-dependent electrophysiological properties of concealed slow pathway according to a functional model of isolated rabbit atrioventricular node preparation after fast pathway ablation. Methods: Experiments were carried out in rabbit isolated heart AV-nodal preparations (N=8) by superfused/perfused mode. Extracellular recording was carried out from transitional cells of posterior and anterior extension of AV-node and upper part of atrium and its bundle. Unipolar silver electrode (100 μm) and direct voltage (100-110 V) was applied to create AV-nodal fast pathway ablation. Results: Minimum conduction time (AHmin) was significantly increased after fast pathway ablation (p<0.05). Fast pathway ablation had no significant impact on fatigue phenomenon but significantly reduced facilitation value (p<0.05). Rate-dependency properties of concealed slow pathway were explained according to functional nodal model. Conclusion: The mathematical functional model accurately simulated frequency-dependent electrophysiological properties of concealed slow pathway after fast pathway ablation, but some modifications are necessary for accurate prediction of nodal behavior in various cycle lengths and in arrhythmia. Concealed slow pathway may be considered as a potential electrophysiological substrate of fatigue and facilitation phenomenon