A Guide to the Porcine Anatomy for the Interventional Electrophysiologist. Fluoroscopy and High Density Electroanatomical Mapping
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Invasive electrophysiology is a rapidly developing field of cardiovascular science with a constant need for inventions and testing of new technologies and concepts. Despite the swine model being an established tool in biomedical research no comprehensive guide for interventional electrophysiologists exists. The aim of the current article is to provide a practical overview of the pig anatomy, fluoroscopic views, and corresponding high density electroanatomic maps using a novel mapping system and a practical guide for interventions and techniques. In 17 pigs, fluoroscopic images of the right atrium, coronary sinus (CS), left atrium, and pulmonary veins as well as the right and left ventricles were obtained and correlated with ultra-high density electroanatomic maps and gross anatomy. Pitfalls of the porcine anatomy are precisely addressed, and alternative access techniques to overcome those issues are suggested. Important differences to human electrophysiological studies are highlighted. Complementary models such as cardiac ischemia induction or renal and pulmonary artery denervation are discussed in detail.
KeywordsPorcine model Cardiac anatomy Ultra-high density mapping
The authors would like to thank Sebastian Weickert, Susanne Ossmann, Sarah Klein, Heart Center Leipzig, and Roberto Bavila and Steve Mure, Boston Scientific for their support of this project.
Conflict of Interest
This study has been supported by an unrestricted Boston Scientific grant to the Heart Center Leipzig. Drs. Bollmann and Kosiuk have received moderate consulting and lecture fees from Boston Scientific.
Left atrium (LA) and right atrium (RA): a) posterior view on the LA and RA, b) anterior view on the RA and LA. The mapping catheter is placed in the RA. The right and left ventricles have been cut out based on electrical signals. (MP4 2309 kb)
Anterior view on the activation map of the right atrium obtained by a) epicardial mapping and b) endocardial mapping. Observe that the area of earliest activation in both maps matches perfectly. (MP4 7415 kb)
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