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(Circulation. 2006;113:2473.)
© 2006 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	IMPACT OF TRANSFORMING GROWTH FACTOR-ß1 ON ATRIOVENTRICULAR NODE CONDUCTION MODIFICATION BY INJECTED AUTOLOGOUS FIBROBLASTS IN THE CANINE HEART, by Bunch et al.

 
Pharmacological treatment of atrial fibrillation using antiarrhythmic agents or ventricular rate control is challenging because of variable success and medication side effects. Catheter ablation also is not 100% successful and carries the risk of procedural complications. In this issue of Circulation, Bunch and colleagues describe a technique of percutaneously injecting cultured fibroblasts from skin biopsies to modulate atrioventricular (AV) nodal conduction and rate control in a canine model. Using electroanatomic mapping and intracardiac echocardiography to guide delivery, they injected fibroblasts (with or without transforming growth factor-ß1) through a NOGA catheter at several AV nodal input regions. Regulation of AV nodal conduction and ventricular rate reduction during induced atrial fibrillation was observed and was more pronounced in dogs receiving transforming growth factor-ß1–treated fibroblast injections. There were no major complications or long-term high-grade AV block. Local cell delivery may eventually be a potential therapeutic option, perhaps combined with medication and/or device therapy to modulate ventricular rate control during atrial arrhythmias. See p 2485 (and editorial on p 2474).

	ENHANCED VENTRICULAR UNTWISTING DURING EXERCISE: A MECHANISTIC MANIFESTATION OF ELASTIC RECOIL DESCRIBED BY DOPPLER TISSUE IMAGING, by Notomi et al.

 
Classical concepts of myocardial function learned by all cardiologists center around pressure-volume relationships in the right and left ventricles. It is important to realize, however, that the sequence and pattern of contraction of the 2 ventricles is different: The right ventricle contracts more like a bellows, but the left ventricle undergoes a complex cycle of twisting and untwisting in systole and diastole. Notomi et al provide a detailed analysis of left ventricular (LV) untwisting both at rest and during exercise using Doppler . . . [Full Text of this Article]

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