Non-linear coupling of atrial activation processes during atrial fibrillation in humans

The activation patterns underlying the electrical activity of the heart during atrial fibrillation (AF) are not entirely random. The aim of this study was to assess the local organization of the activation processes during AF by estimating the non-linear coupling between activation sequences (ASs) in two atrial sites. To quantitatively estimate the degree of non-linear coupling we extracted two indices based on a multivariate embedding procedure and on the estimation of the correlation dimension (CD) and correlation entropy (CE), termed independence of complexity and of independence of predictability, respectively. We analysed AS in two atrial sites in 30 informed subjects during chronic AF of type I, II and III (Wells' classification), ten 6-s-long episodes of each type. Surrogates were used to reject the hypothesis that the time series were generated by linear stochastic dynamics. We estimated CD and CE according to the coarse-grained approach, which leads to a fixed high value for the embedding dimension in all the analysed ASs, and a typical value for the distance between the two ASs in the phase space. Various degrees of organization, ranging from completely synchronized to fully de-coupled signals, were observed: significant degrees of non-linear coupling were found in segments belonging in types I and II AF, whereas type III electrograms always turned out to be weakly coupled. This finding links the morphology of single electrograms to the synchronization between pairs of closely spaced electrograms. Our bivariate approach suggests that the measurement of organization during AF should be based on the estimation of the non-linear coupling between two sites. This approach appears to be more reliable and sensitive than non-linear analysis of single electrograms or linear analysis of their coupling.     

A review on sample entropy applications for the non-invasive analysis of atrial fibrillation electrocardiograms

The application of non-linear metrics to physiological signals is a valuable tool because “hidden information” related to underlying mechanisms can be obtained. In this respect, approximate entropy (ApEn) is the most popular non-linear regularity index that has been applied to physiological time series. However, ApEn presents some shortcomings, such as bias, relative inconsistency and dependence on the sample length. A modification of ApEn, named sample entropy (SampEn), was introduced to overcome these deficiencies. Recently, in the context of electrocardiography, SampEn has been applied to study non-invasively atrial fibrillation (AF), which is the most common arrhythmia encountered in clinical practice with unknown mechanisms provoking its onset and termination. Useful clinical information, that could help for a better understanding of AF mechanisms, has been obtained through the application of SampEn to electrocardiographic (ECG) recordings. This work reviews its application in the context of non-invasive analysis of AF. During this arrhythmia, atrial and ventricular components can be regarded as unsynchronized activities, whereby, the application of SampEn to the analysis of each component will be described separately. In first place, clinical challenges in which SampEn has been successfully applied to estimate AF organization from the atrial activity pattern are presented. The AF organization study can provide information on the number of active reentries, which can help to improve AF treatment and to take the appropriate decisions on its management. Next, the heart rate variability study via SampEn, to characterize ventricular response and predict AF onset, is described. Through the aforementioned applications it is remarked throughout this review that SampEn can be considered as a very promising and useful tool towards the non-invasive understanding of AF.     

Atrial electrogram quality in single-pass defibrillator leads with floating atrial bipole in patients with permanent atrial fibrillation and cardiac resynchronization therapy

Many patients receiving cardiac resynchronization therapy (CRT) suffer from permanent atrial fibrillation (AF). Knowledge of the atrial rhythm is important to direct pharmacological or interventional treatment as well as maintaining AV-synchronous biventricular pacing if sinus rhythm can be restored. A single pass single-coil defibrillator lead with a floating atrial bipole has been shown to obtain reliable information about the atrial rhythm but has never been employed in a CRT-system. The purpose of this study was to assess the feasibility of implanting a single coil right ventricular ICD lead with a floating atrial bipole and the signal quality of atrial electrograms (AEGM) in CRT-defibrillator recipients with permanent AF.

3D virtual human atria: A computational platform for studying clinical atrial fibrillation

Despite a vast amount of experimental and clinical data on the underlying ionic, cellular and tissue substrates, the mechanisms of common atrial arrhythmias (such as atrial fibrillation, AF) arising from the functional interactions at the whole atria level remain unclear. Computational modelling provides a quantitative framework for integrating such multi-scale data and understanding the arrhythmogenic behaviour that emerges from the collective spatio-temporal dynamics in all parts of the heart. In this study, we have developed a multi-scale hierarchy of biophysically detailed computational models for the human atria - the 3D virtual human atria. Primarily, diffusion tensor MRI reconstruction of the tissue geometry and fibre orientation in the human sinoatrial node (SAN) and surrounding atrial muscle was integrated into the 3D model of the whole atria dissected from the Visible Human dataset. The anatomical models were combined with the heterogeneous atrial action potential (AP) models, and used to simulate the AP conduction in the human atria under various conditions: SAN pacemaking and atrial activation in the normal rhythm, break-down of regular AP wave-fronts during rapid atrial pacing, and the genesis of multiple re-entrant wavelets characteristic of AF. Contributions of different properties of the tissue to mechanisms of the normal rhythm and arrhythmogenesis were investigated. Primarily, the simulations showed that tissue heterogeneity caused the break-down of the normal AP wave-fronts at rapid pacing rates, which initiated a pair of re-entrant spiral waves; and tissue anisotropy resulted in a further break-down of the spiral waves into multiple meandering wavelets characteristic of AF. The 3D virtual atria model itself was incorporated into the torso model to simulate the body surface ECG patterns in the normal and arrhythmic conditions. Therefore, a state-of-the-art computational platform has been developed, which can be used for studying multi-scale electrical phenomena during atrial conduction and AF arrhythmogenesis. Results of such simulations can be directly compared with electrophysiological and endocardial mapping data, as well as clinical ECG recordings. The virtual human atria can provide in-depth insights into 3D excitation propagation processes within atrial walls of a whole heart in vivo, which is beyond the current technical capabilities of experimental or clinical set-ups.     

Application of higher order statistics for atrial arrhythmia classification

Atrial fibrillation (AF) and atrial flutter (AFL) are the two common atrial arrhythmia encountered in the clinical practice. In order to diagnose these abnormalities the electrocardiogram (ECG) is widely used. The conventional linear time and frequency domain methods cannot decipher the hidden complexity present in these signals. The ECG is inherently a non-linear, non-stationary and non-Gaussian signal. The non-linear models can provide improved results and capture minute variations present in the time series. Higher order spectra (HOS) is a non-linear dynamical method which is highly rugged to noise. In the present study, the performances of two methods are compared: (i) 3rd order HOS cumulants and (ii) HOS bispectrum. The 3rd order cumulant and bispectrum coefficients are subjected to dimensionality reduction using independent component analysis (ICA) and classified using classification and regression tree (CART), random forest (RF), artificial neural network (ANN) and k-nearest neighbor (KNN) classifiers to select the best classifier. The ICA components of cumulant coefficients have provided the average accuracy, sensitivity, specificity and positive predictive value of 99.50%, 100%, 99.22% and 99.72% respectively using KNN classifier. Similarly, the ICA components of HOS bispectrum coefficients have yielded the average accuracy, sensitivity, specificity and PPV of 97.65%, 98.16%, 98.75% and 99.53% respectively using KNN. So, the ICA performed on the 3rd order HOS cumulants coupled with KNN classifier performed better than the HOS bispectrum method. The proposed methodology is robust and can be used in mass screening of cardiac patients.     

双极射频消融改良迷宫术治疗房颤的中远期疗效及其影响因素分析

目的:分析心脏瓣膜置换同期行双极射频消融改良迷宫术治疗房颤的术后中远期疗效及其影响因素。方法:选取2007年7月至2010年12月于我院行心脏瓣膜置换同期行双极射频消融改良迷宫术治疗房颤的72例患者,术后随访3至6年,获得患者术后十二导联心电图、24 h动态心电图和心脏彩超结果,并且记录术后药物应用、相关并发症、心功能恢复情况及生活质量是否改善等情况。根据心电图结果,将患者分为窦性心律组与非窦性心律组,应用统计学方法比较两组患者术前相关因素是否有差异。结果:截止至随访终点,有效随访的68例患者中窦性心律维持率为63.2%。单因素分析显示术前房颤病程、术前左室射血分数、是否合并三尖瓣成形或置换是影响手术效果的影响因素,多因素分析显示术前房颤病程、合并三尖瓣成形或置换是影响手术效果的危险因素。结论:心脏瓣膜置换同期行双极射频消融改良迷宫术治疗房颤的中晚期疗效好,术后并发症少,能够有效防止血栓栓塞,术前房颤病程长、合并三尖瓣成形或置换的患者术后中远期效果相对较差。     

What are the post-ablation insular residual electrograms in the posterior left pulmonary veins electrically connected to?

A 67-year-old man underwent a third ablation procedure for a recurrent atrial tachycardia (AT) after an extensive pulmonary vein (PV) isolation, linear ablation along the left atrial (LA) roof and posterolateral mitral isthmus (MI), and defragmentation of persistent atrial fibrillation and an induced perimitral AT. High-resolution mapping during the clinical AT using the Rhythmia system (Boston Scientific) suggested that the AT was a ridge-related reentrant AT and exhibited a reconnection of the left PVs (LPVs). The residual electrograms in the posterior LPVs were surrounded by endocardial scar, which was like an island consisting of residual LPV electrograms. Retrograde venography of the vein of Marshall (VOM) demonstrated that the VOM reached the posterior left superior PV through the ridge between the LA appendage and left inferior PV and then the LPV carina. An ethanol infusion into the VOM resulted in a simultaneous AT termination and complete electrical isolation of the LPVs, that is, the disappearance of the residual LPV electrograms. The insular residual LPV electrograms in the present case did not appear to be endocardially connected to the LA, because the LPV electrograms were surrounded by endocardial scar and there was a large time gap between the earliest activation in the posterior LPVs and activation in the surrounding area. The VOM course on the venography and elimination of the residual LPV electrograms with an ethanol infusion into the VOM suggested that the insular residual LPV electrograms were electrically connected to the posterolateral LA via the VOM and its branches.     

A New Algorithm to Diagnose Atrial Ectopic Origin from Multi Lead ECG Systems - Insights from 3D Virtual Human Atria and Torso

Rapid atrial arrhythmias such as atrial fibrillation (AF) predispose to ventricular arrhythmias, sudden cardiac death and stroke. Identifying the origin of atrial ectopic activity from the electrocardiogram (ECG) can help to diagnose the early onset of AF in a cost-effective manner. The complex and rapid atrial electrical activity during AF makes it difficult to obtain detailed information on atrial activation using the standard 12-lead ECG alone. Compared to conventional 12-lead ECG, more detailed ECG lead configurations may provide further information about spatio-temporal dynamics of the body surface potential (BSP) during atrial excitation. We apply a recently developed 3D human atrial model to simulate electrical activity during normal sinus rhythm and ectopic pacing. The atrial model is placed into a newly developed torso model which considers the presence of the lungs, liver and spinal cord. A boundary element method is used to compute the BSP resulting from atrial excitation. Elements of the torso mesh corresponding to the locations of the placement of the electrodes in the standard 12-lead and a more detailed 64-lead ECG configuration were selected. The ectopic focal activity was simulated at various origins across all the different regions of the atria. Simulated BSP maps during normal atrial excitation (i.e. sinoatrial node excitation) were compared to those observed experimentally (obtained from the 64-lead ECG system), showing a strong agreement between the evolution in time of the simulated and experimental data in the P-wave morphology of the ECG and dipole evolution. An algorithm to obtain the location of the stimulus from a 64-lead ECG system was developed. The algorithm presented had a success rate of 93%, meaning that it correctly identified the origin of atrial focus in 75/80 simulations, and involved a general approach relevant to any multi-lead ECG system. This represents a significant improvement over previously developed algorithms.     

Mechanisms of perpetuation of atrial fibrillation in chronically dilated atria

The progressive nature of atrial fibrillation (AF) has been demonstrated in numerous experimental as well as clinical investigations. Electrical remodeling (shortening of atrial refractoriness) develops within the first days of AF and contributes to the increase in stability of the arrhythmia. However, "domestication of AF" must also depend on other mechanisms since the stability of AF continues to increase after electrical remodeling has been completed. Chronic atrial stretch induces activation of numerous signaling pathways leading to cellular hypertrophy, fibroblast proliferation and tissue fibrosis. The resulting electro-anatomical substrate is characterized by increased non-uniform anisotropy and local conduction heterogeneities facilitating reentry in the dilated atria. Atrial fibrosis may lead to disruption of the electrical side-to-side junctions between muscle bundles. This can result in electrical dissociation between neighboring muscle bundles, i.e. they become activated out-of-phase. Recent mapping studies in goats with persistent AF showed that electrical dissociation can not only occur between neighboring muscle bundles but also in the third dimension, i.e. between the epicardial layer and the endocardial bundle network. Such endo-epicardial dissociation will significantly increase the number of wavefronts which can simultaneously be present in the atrial wall. This article reviews data suggesting a role of endo-epicardial dissociation in dilated and fibrillating atria, for the self-perpetuating nature of AF as well as its possible implications for therapeutic interventions.     

Nonlinear synchronization assessment between atrial and ventricular activations series from the surface ECG in atrial fibrillation

Atrial fibrillation (AF) is the most common form of arrhythmia encountered in clinical practice. Its presence causes a rapid and irregular ventricular response, being the topic of intensive research in rate control therapies of AF. To this respect, recent studies suggest that ventricular response is notably influenced by atrial activity (AA) temporal organization. However, the interdependency between atrial and ventricular activations has not been adequately explored to date in real-life AF patients. The present work introduces a novel methodology to quantitatively assess synchronization and coupling between real atrial and ventricular activation series. Furthermore, the method operates on surface ECG recordings, thus providing an easy and cost-effective way to be applied. The method is based on a nonlinear index, such as cross-sample entropy (CSE), which estimates the conditional probability to find similar patterns within both activation series. The study has been carried out on patients with paroxysmal and persistent AF in order to be applied over atrial activation series with different properties in their organization. Results showed a statistically significant positive correlation between AA organization and the synchronization between atrial and ventricular activations (R = 0.53, p < 0.01). Furthermore, higher CSE values were observed for persistent (0.759 ± 0.053) than for paroxysmal AF episodes (0.662 ± 0.091), thus suggesting more synchronization between atrial and ventricular activations in paroxysmal AF. As a consequence, CSE provided findings consistent with previous works and could be used to reveal clinically useful information in the improvement of current rate control therapies, which are mainly focused on controlling ventricular rate without paying much attention to the atrial fibrillatory process.     

Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia

Over 7 million people worldwide die annually from erratic heart rhythms (cardiac arrhythmias), and many more are disabled. Yet there is no imaging modality to identify patients at risk, provide accurate diagnosis and guide therapy. Standard diagnostic techniques such as the electrocardiogram (ECG) provide only low-resolution projections of cardiac electrical activity on the body surface. Here we demonstrate the successful application in humans of a new imaging modality called electrocardiographic imaging (ECGI), which noninvasively images cardiac electrical activity in the heart. In ECGI, a multielectrode vest records 224 body-surface electrocardiograms; electrical potentials, electrograms and isochrones are then reconstructed on the heart's surface using geometrical information from computed tomography (CT) and a mathematical algorithm. We provide examples of ECGI application during atrial and ventricular activation and ventricular repolarization in (i) normal heart (ii) heart with a conduction disorder (right bundle branch block) (iii) focal activation initiated by right or left ventricular pacing, and (iv) atrial flutter.     

Effect of atrial dilatation on the tendency of atrial arrhythmias

The arrhythmogenic effect of atrial dilatation was studied by electrophysiological investigations carried out on 24 dogs. Atrial distension was evoked by increasing the pressure in the right atrium (12 to 14 mm Hg) or by the balloon dilatation of the left atrium. Programmed electrical stimulation of the heart was used for the electrophysiological investigations. In addition to the superficial ECG leads also atrial and ventricular epicardial electrograms were obtained for the ECG recording. Acute atrial dilatation led to shortening of the atrial refractory period, whereas neither impulse conduction of the heart, nor pacemaker activity of the sinus node exhibited any alteration. Atrial dilatation resulted in pathological atrial irritability, and early or frequent atrial stimulation caused atrial tachycardia of shorter (non sustained) or longer (sustained) duration. Repetitive atrial extrasystoles in response to early stimuli could also frequently be observed during atrial dilatation. The obtained results indicate that atrial dilatation is arrhythmogenic and may lead to the development of atrial tachycardia.     

Atrial flutter and atrial tachycardia detection using Bayesian approach with high resolution time–frequency spectrum from ECG recordings

Contemporary methods of atrial flutter (AFL), atrial tachycardia (AT), and atrial fibrillation (AF) monitoring, although superior to the standard 12-lead ECG and symptom-based monitoring, are unable to accurately discriminate between AF, AFL and AT. Thus, there is a need to develop accurate, automated, and comprehensive atrial arrhythmia detection algorithms using standard ECG recorders. To this end, we have developed a sensitive and real-time realizable algorithm for accurate AFL and AT detection using any standard electrocardiographic recording. Our novel method for automatic detection of atrial flutter and atrial tachycardia uses a Bayesian approach followed by a high resolution time–frequency spectrum. We find the TQ interval of the electrocardiogram (ECG) corresponding to atrial activity by using a particle filter (PF), and analyze the atrial activity with a high resolution time–frequency spectral method: variable frequency complex demodulation (VFCDM). The rationale for using a high-resolution time–frequency algorithm is that our approach tracks the time-varying fundamental frequency of atrial activity, where AT is within 2.0–4.0 Hz, AFL is within 4.0–5.3 Hz and NSR is found at frequencies less than 2.0 Hz. For classifications of AFL (n = 22), AT (n = 10) and normal sinus rhythms (NSR) (n = 29), we found that our approach resulted in accuracies of 0.89, 0.87 and 0.91, respectively; the overall accuracy was 0.88.     

Mechanical modulation of atrial flutter cycle length

Although atrial flutter (AFL) is considered a highly regular rhythm, small fluctuations in cycle length have been described. The mechanisms responsible for these interval oscillations have been investigated by recent studies in humans which have shown that cyclic variations in atrial volume and pressure following ventricular contraction may account for the spontaneous variability of AFL. Other studies have shown that variations in the dimensions of the atria, caused by hemodynamical alterations due to imposed manoeuvres, directly modify the rate of AFL. All this evidence has led to the development of the mechano-electrical feedback (MEF) hypothesis, which assumes that changes in atrial volume directly affect AFL cycle length variability by modifying the conduction properties of the circulating impulse in the atrium.In the present study, we re-examined the variability pattern of typical AFL by spectral analysis aiming to support the MEF hypothesis for AFL cycle length variability. In a study population of 30 patients with typical AFL, we observed that AFL cycle length presented a spontaneous beat-to-beat variability, composed of two oscillations: a main oscillation at the frequency of ventricular contraction (1.70±0.48 Hz, spectral power: 15.4±17.6 ms²) and a second oscillation at the frequency of respiration (0.32±0.07 Hz, spectral power: 2.9±2.6 ms²). Both ventricular and respiratory oscillations persisted after pharmacologic autonomic blockade (ventricular spectral power: 17.7±14.7 ms² (before block) vs 20.2±18.3 ms² (after block), p=NS; respiratory spectral power: 6.0±3.8 ms² (before block) vs 5.0±3.4 ms² (after block), p=NS), suggesting a non-neurally mediated underlying mechanism. Contrary to respiratory modulation of heart rate during sinus rhythm, respiratory AFL cycle length oscillations displayed a reverse pattern, with longer cycle lengths during inspiration and shorter during expiration (AA_insp=223.2±28.6 ms vs AA_exp=221.1±28.2 ms, p<0.0005), which was consistent with a mechanical modulation of AFL reentry.The use of spectral analysis techniques applied to ventricular interval series and combined with computer simulations of atrioventricular conduction showed that the respiratory oscillation of atrial cycle length determined an oscillation in ventricular intervals with longer intervals during inspiration and shorter during expiration (VV_insp=639.9±186.0 ms vs VV_exp=634.8±182.9 ms, p<0.05). Ventricular interval oscillations resulted amplified by a factor 1.8 with respect to corresponding atrial cycle length oscillations. Thus, the mechanical fluctuations in AFL cycle length, although of small amplitude, might become clinically relevant through a magnified effect on ventricular variability.     

Rapid fluctuations in atrial fibrillatory electrophysiology detected during controlled respiration

Heart rate during sinus rhythm is modulated through the autonomic nervous system, which generates short-term oscillations. The high-frequency components in these oscillations are associated with respiration, causing sinus arrhythmia, mediated by the parasympathetic nervous system. In this study, we evaluated whether slow, controlled respiration causes cyclic fluctuations in the frequency of the fibrillating atria. Eight patients (four women; median age 63 yr, range 53-68 yr) with chronic atrial fibrillation (AF) and third-degree atrioventricular block treated by permanent pacemaker were studied. ECG was recorded during baseline rest, during 0.125-Hz frequency controlled respiration, and finally during controlled respiration after full vagal blockade. We calculated fibrillatory frequency using frequency analysis of the fibrillatory ECG for overlapping 2.5-s segments; spectral analysis of the resulting frequency trend was performed to determine the spectrum of variations of fibrillatory frequency. Normalized spectral power at respiration frequency increased significantly during controlled respiration from 1.4 (0.76-2.0) (median and range) at baseline to 2.7 (1.2-5.8) (P = 0.01). After vagal blockade, the power at respiration frequency decreased to 1.2 (0.23-2.8) (P = 0.01). Controlled respiration causes cyclic fluctuations in the AF frequency in patients with long-duration AF. This phenomenon seems to be related to parasympathetic modulations of the AF refractory period.     

The usefulness of ventricular pacing during atrial fibrillation ablation in a persistent left superior vena cava: A case report

A 69-year-old woman with palpitations was referred to our hospital for a second session of atrial fibrillation (AF) catheter ablation. She had a history of AF ablation including pulmonary vein (PV) isolation and persistent left superior vena cava (PLSVC) isolation. Electrophysiologic studies showed the veno-atrial connections that had recovered. After PV isolation was performed, AF was induced by atrial premature contraction (APC) from the PLSVC, and AF storm occurred. During PLSVC isolation, AF was not induced by APC from the PLSVC. PLSVC isolation continued during sinus rhythm. The elimination of the PLSVC potential was difficult to confirm because of the far-field potential of the left ventricle. Then, we performed right ventricular pacing. The remaining PLSVC potential was identified. After that, the PLSVC isolation was successful during right ventricular pacing. Complications were not observed. The patient had no recurrence of AF thereafter.     

Noninvasive detection of epicardial and endocardial activity of the heart

Determining electrical activation of the heart in a noninvasive way is one of the challenges in cardiac electrophysiology. The ECG provides some, but limited information about the electrical status of the heart. This article describes a method to determine both endocardial and epicardial activation of the heart of an individual patient from 64 electrograms recorded from the body surface. Information obtained in this way might be helpful for the treatment of arrhythmias, to assess the effect of drugs on conduction in the heart and to assess electrical stability of the heart.     

Can Right Ventricular Pacing be Useful in the Assessment of Cavo-tricuspid Isthumus Block?

Background

Cavo-tricuspid isthmus (CTI) block is currently assessed by coronary sinus (CS) pacing or low lateral and septal atrial pacing. Occasionally, CS catheterization through the femoral route can be difficult to perform or right atrial pacing can be problematic because of catheter instability or saturation of the atrial electrograms recorded near the catheter.

Objectives

Our aim was to evaluate the feasibility of assessing cavo-tricuspid isthmus block by means of right ventricular (RV) pacing in patients with ventriculo-atrial conduction, comparing it with CS pacing.

Methods

Circumannular activation was analyzed during CS and RV pacing in consecutive patients in sinus rhythm undergoing CTI ablation for typical atrial flutter. Patients without ventriculo-atrial conduction were excluded from the study. The linear lesion was created during RV pacing and split atrial signals on the ablation line were analyzed. CTI block was confirmed by analyzing local electrograms on the line of block and circumannular activation during CS and RV pacing.

Results

Out of 31 patients, 20 displayed ventriculo-atrial conduction (64%) and were included in the study. Before ablation, during RV stimulation, the collision front of circumannular activation shifted counterclockwise in contrast with the pattern observed during CS pacing. After ablation, circumannular activation was similar during CS and RV pacing, showing fully descending lateral right atrium activation, even if double potentials registered on the ablation line were less widely split during RV pacing than CS pacing (111±26 ms vs 128±30 , p=0.0001).

Conclusions

In patients with ventriculo-atrial conduction, tricuspid annulus activation during CS and RV pacing is similar, before and after CTI ablation. The occurrence of split atrial electrograms separated by an isoelectric interval registered on the line of block can be detected during CS or RV pacing. In patients with difficult CS catheterization via the femoral vein, before trying the subclavian or internal jugular route, if retrograde ventriculo-atrial conduction is present, RV pacing can be an easy trick to assess isthmus block.     

Blood cleansing in heart atrium of <Emphasis Type="Italic">Trichogaster leerii</Emphasis> (Bleeker, 1852), Anabantidae: Teleostei

The capability and capacity of endocardial tissue in heart of Trichogaster leerii (Pearl gourami) to take up intraperitoneally injected horse-spleen ferritin and the regular content of indigestible wastes in this tissue are described. The entire heart wall was spongy composed of muscle trabeculae enveloped by flat endocardial cells. In atrium these cells were filled by Prussian blue precipitations in sections treated with acid ferrocyanide, when the period of time between ferritin-injection and sacrifice was 6 h or more. The endocardial cell layers enveloping the muscle trabeculae in ventricle or covering the wall and valves of the ventricular apertures nearly lacked such precipitations. Those endocardial cell layers capable to endocytose much foreign ferritin, also reacted strongly with Schmorl’s solution in control hearts, i.e. these atrial cells are normally rich in indigestible wastes, probably lipofuscin. We suggest that the endocytic and lipofuscin-rich endocardial cells in heart atrium may play a role in the blood clearance in T. leerii and that this cleansing in heart is restricted to atrium only in this species.