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Compartmentalized Structure of the Moderator Band Provides a Unique Substrate for Macroreentrant Ventricular Tachycardia

hal.structure.identifierIHU-LIRYC
dc.contributor.authorWALTON, Richard
hal.structure.identifierCenter for Computational Imaging and Simulation Technologies in Biomedicine [CISTIB]
dc.contributor.authorPASHAEI, Ali
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorMARTINEZ, Marine
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorCONSTANTIN, Marion
hal.structure.identifierIHU-LIRYC
dc.contributor.authorDUCHATEAU, Josselin
hal.structure.identifierInstitut National de la Santé et de la Recherche Médicale [INSERM]
dc.contributor.authorBEAR, Laura
hal.structure.identifierIHU-LIRYC
dc.contributor.authorCROS, Caroline
hal.structure.identifierIHU-LIRYC
dc.contributor.authorPASCAREL-AUCLERC, Caroline
hal.structure.identifierIHU-LIRYC
dc.contributor.authorGUO, Yunbo
hal.structure.identifierIHU-LIRYC
dc.contributor.authorBENOIST, David
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorDUBES, Virginie
hal.structure.identifierLaboratoire Ondes et Matière d'Aquitaine [LOMA]
dc.contributor.authorFAYE, Ndeye Rokhaya
hal.structure.identifierIHU-LIRYC
dc.contributor.authorCHAIGNE, Sebastien
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorDUPUIS, Sebastien
hal.structure.identifierIHU-LIRYC
dc.contributor.authorDETAILLE, Dominique
hal.structure.identifierCentre de résonance magnétique des systèmes biologiques [CRMSB]
dc.contributor.authorPOURTAU, Line
hal.structure.identifierIHU-LIRYC
dc.contributor.authorPASDOIS, Philippe
hal.structure.identifierIHU-LIRYC
dc.contributor.authorBRETTE, Fabien
hal.structure.identifierIHU-LIRYC
dc.contributor.authorROGIER, Julien
hal.structure.identifierIHU-LIRYC
dc.contributor.authorLABROUSSE, Louis
hal.structure.identifierIHU-LIRYC
dc.contributor.authorHOCINI, Mélèze
hal.structure.identifierModélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
dc.contributor.authorVIGMOND, Edward
hal.structure.identifierIHU-LIRYC
dc.contributor.authorHAÏSSAGUERRE, Michel
hal.structure.identifierIHU-LIRYC
dc.contributor.authorBERNUS, Olivier
dc.date.issued2018-08
dc.identifier.issn1941-3149
dc.description.abstractEnBackground Papillary muscles are an important source of ventricular tachycardia (VT). Yet little is known about the role of the right ventricular (RV) endocavity structure, the moderator band (MB). The aim of this study was to determine the characteristics of the MB that may predispose to arrhythmia substrates. Methods Ventricular wedge preparations with intact MBs were studied from humans (n=2) and sheep (n=15; 40-50 kg). RV endocardium was optically mapped, and electrical recordings were measured along the MB and septum. S1S2 pacing of the RV free wall, MB, or combined S1-RV S2-MB sites were assessed. Human (n=2) and sheep (n=4) MB tissue constituents were assessed histologically. Results The MB structure was remarkably organized as 2 excitable, yet uncoupled compartments of myocardium and Purkinje. In humans, action potential duration heterogeneity between MB and RV myocardium was found (324.6±12.0 versus 364.0±8.4 ms; P<0.0001). S1S2-MB pacing induced unidirectional propagation via MB myocardium, permitting sustained macroreentrant VT. In sheep, the incidence of VT for RV, MB, and S1-RV S2-MB pacing was 1.3%, 5.1%, and 10.3%. Severing the MB led to VT termination, confirming a primary arrhythmic role. Inducible preparations had shorter action potential duration in the MB than RV (259.3±45.2 versus 300.7±38.5 ms; P<0.05), whereas noninducible preparations showed no difference (312.0±30.3 versus 310.0±24.6 ms, respectively). Conclusions The MB presents anatomic and electrical compartmentalization between myocardium and Purkinje fibers, providing a substrate for macroreentry. The vulnerability to sustain VT via this mechanism is dependent on MB structure and action potential duration gradients between the RV free wall and MB.
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.subject.enPurkinje fibers
dc.subject.enAction potentials
dc.subject.enHeart ventricles
dc.subject.enPapillary muscles
dc.subject.enTachycardia
dc.subject.enVentricular
dc.title.enCompartmentalized Structure of the Moderator Band Provides a Unique Substrate for Macroreentrant Ventricular Tachycardia
dc.typeArticle de revue
dc.identifier.doi10.1161/CIRCEP.117.005913
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
bordeaux.journalCirculation. Arrhythmia and electrophysiology
bordeaux.pagee005913
bordeaux.volume11
bordeaux.issue8
bordeaux.peerReviewedoui
hal.identifierhal-02885630
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-02885630v1
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