Quantification of fiber orientation in the canine atrial pacemaker complex using optical coherence tomography

Abstract The atrial pacemaker complex is responsible for the initiation and early propagation of cardiac impulses. Optical coherence tomography (OCT), a nondestructive imaging modality with spatial resolutions of ∼1 to 15 μm, can be used to identify unique fiber orientation patterns in this region of the heart. Functionally characterized canine sinoatrial nodes (SAN) (n=7) were imaged using OCT up to ∼1  mm below the endocardial tissue surface. OCT images were directly compared to their corresponding histological sections. Fiber orientation patterns unique to the crista terminalis (CT), SAN, and surrounding atrial myocardium were identified with dominant average fiber angles of 89±12  deg, 110±16  deg, and 95±35  deg, respectively. Both the CT and surrounding atrial myocardium displayed predominantly unidirectionally based fiber orientation patterns within each specimen, whereas the SAN displayed an increased amount of fiber disarray manifested quantitatively as a significantly greater standard deviation in fiber angle distribution within specimens [33±7  deg versus 23±5  deg, atrium (p=0.02); 18±3  deg, CT (p=0.0003)]. We also identified unique, local patterns of fiber orientation specific to the functionally characterized block zone. We demonstrate the ability of OCT in detecting components of the atrial pacemaker complex which are intimately involved in both normal and abnormal cardiac conduction.

[1]  Andrew M Rollins,et al.  Real-time monitoring of cardiac radio-frequency ablation lesion formation using an optical coherence tomography forward-imaging catheter. , 2010, Journal of biomedical optics.

[2]  D. Sánchez-Quintana,et al.  Sinus node revisited in the era of electroanatomical mapping and catheter ablation , 2005, Heart.

[3]  Paul A Iaizzo,et al.  Connexin 43 Expression Delineates Two Discrete Pathways in the Human Atrioventricular Junction , 2008, Anatomical record.

[4]  Robert H. Anderson,et al.  Computer Three‐Dimensional Anatomical Reconstruction of the Human Sinus Node and a Novel Paranodal Area , 2011, Anatomical record.

[5]  Vadim V Fedorov,et al.  Structural and Functional Evidence for Discrete Exit Pathways That Connect the Canine Sinoatrial Node and Atria , 2009, Circulation research.

[6]  M. Boyett,et al.  The Anatomy and Physiology of the Sinoatrial Node—A Contemporary Review , 2010, Pacing and clinical electrophysiology : PACE.

[7]  Michael W. Jenkins,et al.  Optical Coherence Tomography Imaging of the Purkinje Network , 2005, Journal of cardiovascular electrophysiology.

[8]  A. Rollins,et al.  Quasi-telecentric optical design of a microscope-compatible OCT scanner. , 2005, Optics Express.

[9]  Leslie M Loew,et al.  Optical mapping of the isolated coronary-perfused human sinus node. , 2010, Journal of the American College of Cardiology.

[10]  H Honjo,et al.  Computer Three-Dimensional Reconstruction of the Sinoatrial Node , 2005, Circulation.

[11]  A. Fercher,et al.  Submicrometer axial resolution optical coherence tomography. , 2002, Optics letters.

[12]  Nader Moazami,et al.  Virtual histology of the human heart using optical coherence tomography. , 2009, Journal of biomedical optics.

[13]  R B Schuessler,et al.  Primary negativity does not predict dominant pacemaker location: implications for sinoatrial conduction. , 1995, The American journal of physiology.

[14]  Vadim V Fedorov,et al.  Bimodal biophotonic imaging of the structure-function relationship in cardiac tissue. , 2008, Journal of biomedical optics.

[15]  A E Becker,et al.  Functional and Morphological Organization of the Rabbit Sinus Node , 1980, Circulation research.

[16]  P B Corr,et al.  Demonstration of a widely distributed atrial pacemaker complex in the human heart. , 1988, Circulation.

[17]  H. Zhang,et al.  Connexins in the sinoatrial and atrioventricular nodes. , 2006, Advances in cardiology.

[18]  M. Allessie,et al.  Structural changes of atrial myocardium due to sustained atrial fibrillation in the goat. , 1997, Circulation.

[19]  J. Fujimoto.  Optical coherence tomography for ultrahigh resolution in vivo imaging , 2003, Nature Biotechnology.

[20]  B E Bouma,et al.  Images in cardiovascular medicine. Catheter-based optical imaging of a human coronary artery. , 1996, Circulation.

[21]  Colleen E. Clancy,et al.  Determinants of Heterogeneity, Excitation and Conduction in the Sinoatrial Node: A Model Study , 2010, PLoS Comput. Biol..

[22]  S. F. Lin,et al.  Dynamics of intramural and transmural reentry during ventricular fibrillation in isolated swine ventricles. , 2001, Circulation research.

[23]  Andrew M. Rollins,et al.  Quantification of cardiac fiber orientation using optical coherence tomography. , 2008, Journal of biomedical optics.

[24]  Robert H. Anderson,et al.  Molecular Architecture of the Human Sinus Node: Insights Into the Function of the Cardiac Pacemaker , 2009, Circulation.

[25]  I. Efimov,et al.  Postganglionic nerve stimulation induces temporal inhibition of excitability in rabbit sinoatrial node. , 2006, American journal of physiology. Heart and circulatory physiology.

[26]  T. N. James,et al.  Anatomy of the sinus node of the dog , 1962, The Anatomical record.

[27]  I. Efimov,et al.  Complex interactions between the sinoatrial node and atrium during reentrant arrhythmias in the canine heart. , 2010, Circulation.

[28]  P. Sanders,et al.  Electrophysiological and Electroanatomic Characterization of the Atria in Sinus Node Disease: Evidence of Diffuse Atrial Remodeling , 2003, Circulation.

[29]  Richard B Schuessler,et al.  Abnormal Sinus Node Function in Clinical Arrhythmias , 2003, Journal of cardiovascular electrophysiology.

[30]  H Honjo,et al.  The sinoatrial node, a heterogeneous pacemaker structure. , 2000, Cardiovascular research.

[31]  Joseph A Izatt,et al.  Imaging of the Atrioventricular Node Using Optical Coherence Tomography , 2002, Journal of cardiovascular electrophysiology.