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Volume 13, Issue 11, Pages 2111-2117 (November 2016) Acute effects of unilateral temporary stellate ganglion block on human atrial electrophysiological properties and atrial fibrillation inducibility Dionyssios Leftheriotis, MD, Panayota Flevari, MD, Charalampos Kossyvakis, MD, Dimitrios Katsaras, MD, Chrysanthi Batistaki, MD, Chrysa Arvaniti, MD, Georgios Giannopoulos, MD, Spyridon Deftereos, MD, Georgia Kostopanagiotou, MD, PhD, John Lekakis, MD Heart Rhythm Volume 13, Issue 11, Pages 2111-2117 (November 2016) DOI: 10.1016/j.hrthm.2016.06.025 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Right and left effective refractory period (RAERP and LAERP) before and after stellate ganglion block (SGB). During pacing at 600-ms cycle length from the high right atrium, RAERP was prolonged from 200 ms before (A) to 240 ms after (B) block. Similarly, LAERP was 220 ms before (C) and 280 ms after (D) SGB during pacing from the distal coronary sinus. Electrocardiographic leads II, aVR, V1, V2, and V5, along with electrograms from the high right atrium distal (HRAd) and proximal (HRAp), His area distal to proximal (Hisd, His2, His3, His4, Hisp), coronary sinus distal to proximal (CSd, CS2, CS3, CS4, CSp), and right ventricular apex distal (RVAd) and proximal (RVAp), are presented. Heart Rhythm 2016 13, 2111-2117DOI: (10.1016/j.hrthm.2016.06.025) Copyright © 2016 The Authors Terms and Conditions

Figure 2 Conduction time measurements. Right intra-atrial conduction time (A), left intra-atrial conduction time (B), right interatrial conduction time (C), and left interatrial conduction time (D) are measured as described in the text. Abbreviations as in Figure 1. Heart Rhythm 2016 13, 2111-2117DOI: (10.1016/j.hrthm.2016.06.025) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Atrial fibrillation (AF) inducibility before and after stellate ganglion block (SGB). Initially, AF was induced with rapid atrial pacing at 200-ms cycle length (A). After SBG, AF was not inducible with the same pacing protocol (B). Abbreviations as in Figure 1. Heart Rhythm 2016 13, 2111-2117DOI: (10.1016/j.hrthm.2016.06.025) Copyright © 2016 The Authors Terms and Conditions

Figure 4 Box plot graph of right (RAERP) and left (LAERP) atrial effective refractory periods before (pre) and after (post) stellate ganglion block (SGB). The thick horizontal black line corresponds to the median, the box to the interquartile range, and the whiskers to the range of observed values. Heart Rhythm 2016 13, 2111-2117DOI: (10.1016/j.hrthm.2016.06.025) Copyright © 2016 The Authors Terms and Conditions