Cell Unexcitability and Electrotonic Coupling Phenomenon Analysis of Ablation-Created Lesions: A Study Case with Ablated Explanted Human Heart.

This study investigates the effects of radiofrequency ablation (RFA)-created lesions on an explanted human heart in wedge preparation by simultaneous endo and sub-endo optical mapping. The heart in Langendorff perfusion was ablated under 40 W. The ventricle was stained with Vm sensitive dye Di-4-ANBDQPQ and two excitation light bands of different penetration depths were used (red = 660 nm, green = 525 nm) to perform a conduction velocity (CV) difference analysis for identification of CV alter-nans. The relative change in fluorescence (ΔF/F) traces were analyzed before and after ablation. Local activation time (LAT) was determined by the 50% approach. Local CV was obtained using the circle method, and RFA created lesions were characterized by examining the CV alternans correlated with transmural heterogeneities. The presence of CV alternans results from reduced excitability in a non-homogeneous lesion consisting of excitable and non-excitable cells. The absence of CV alternans in optical mapping with green light and their presence with deep-red light illustrates incomplete ablation across the ventricular wall or non-homogeneous ablation in the mid-myocardial layer. The presence of an intramural scar impairs the efficacy of the RFA procedure, suggesting a need for alternative ablations strategies.

Cardiomyocyte cultures with controlled macroscopic anisotropy: a model for functional electrophysiological studies of cardiac muscle.

Structural and functional cardiac anisotropy varies with the development, location, and pathophysiology in the heart. The goal of this study was to design a cell culture model system in which the degree, change in fiber direction, and discontinuity of anisotropy can be controlled over centimeter-size length scales. Neonatal rat ventricular myocytes were cultured on fibronectin on 20-mm diameter circular cover slips. Structure-function relationships were assessed using immunostaining and optical mapping. Cell culture on microabraded cover slips yielded cell elongation and coalignment in the direction of abrasion, and uniform, macroscopically continuous, elliptical propagation with point stimulation. Coarser microabrasion (wider and deeper abrasion grooves) increased longitudinal (23.5 to 37.2 cm/s; r=0.66) and decreased transverse conduction velocity (18.1 to 9.2 cm/s; r=-0.84), which resulted in increased longitudinal-to-transverse velocity anisotropy ratios (1.3 to 3.7, n=61). A thin transition zone between adjacent uniformly anisotropic areas with 45 degrees or 90 degrees difference in fiber orientation acted as a secondary source during 2x threshold field stimulus. Cell culture on cover slips micropatterned with 12- or 25- micro m wide fibronectin lines and previously coated with decreasing concentrations of background fibronectin yielded transition from continuous to discontinuous anisotropic architecture with longitudinally oriented intercellular clefts, decreased transverse velocity (16.9 to 2.6 cm/s; r=-0.95), increased velocity anisotropy ratios (1.6 to 5.6, n=70), and decreased longitudinal velocity (36.4 to 14.6 cm/s; r=-0.85) for anisotropy ratios >3.5. Cultures of cardiac myocytes with controlled degree, uniformity and continuity of structural, and functional anisotropy may enable systematic 2-dimensional in vitro studies of macroscopic structure-related mechanisms of reentrant arrhythmias. The full text of this article is available at http://www.circresaha.org.