{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:54:12Z","timestamp":1788411252396,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Ganglionated plexi (GPs) play an important role in both the initiation and maintenance of atrial fibrillation (AF). GPs can be located by using continuous high-frequency stimulation (HFS) to elicit a vagal response, but whether the vagal response phenomenon is common to patients without AF is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>HFS of the left atrial GPs was performed in 42 patients (aged 58.0\u00b110.2 years) undergoing ablation for AF and 21 patients (aged 53.2\u00b112.8 years) undergoing ablation for a left-sided accessory pathway. The HFS (20 Hz, 25 mA, 10-ms pulse duration) was applied for 5 seconds at 3 sites within the presumed anatomic area of each of the 5 major left atrial GPs (for a total of 15 sites per patient). We defined vagal response to HFS as prolongation of the R-R interval by &gt;50% in comparison to the mean pre-HFS R-R interval averaged over 10 beats and active-GP areas as areas in which a vagal response was elicited.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Overall, more active-GP areas were found in the AF group patients than in the non-AF group patients, and at all 5 major GPs, the maximum R-R interval during HFS was significantly prolonged in the AF patients. After multivariate adjustment, association was established between the total number of vagal response sites and the presence of AF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The significant increase in vagal responses elicited in patients with AF compared with responses in non-AF patients suggests that vagal responses to HFS reflect abnormally increased GP activity specific to AF substrates.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.118.007281","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T09:00:32Z","timestamp":1571130032000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Is Vagal Response During Left Atrial Ganglionated Plexi Stimulation a Normal Phenomenon?"],"prefix":"10.1161","volume":"12","author":[{"given":"Kazuki","family":"Iso","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Nagashima","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Arai","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuta","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Wakamatsu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seina","family":"Yagyu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayaka","family":"Kurokawa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiko","family":"Nakai","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimie","family":"Ohkubo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, 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