Cardiomyocyte progenitors in a canine pulmonary vein model of persistent atrial fibrillation.

This study aimed to discover the pathogenesis of focal atrial fibrillation (AF) originating from pulmonary veins by observing the histological structure and special cells in the canine pulmonary vein model of persistent atrial fibrillation. The pulmonary veins and the sinus node were obtained from 10 mongrel dogs (5 AF and 5 control group). Light microscopy, transmission electron microscopy, and immunohistochemistry were applied to transverse sections of each pulmonary vein and sinoatrial node. Morphological and distribution analyses were performed manually and automatically. Cardiomyocyte progenitor (CMPs) and interstitial cells of Cajal (ICCs) showing typical features of either very immature or developing cells were found in the pulmonary vein sections of all animals subjected to experimental AF but not in the control group. The cells were mainly identified in sections with a thick muscular sleeve. A positive immunostaining of CMPs was also demonstrated; the staining characteristic was similar to that of P cells in the sinoatrial node, suggesting that these cells may function in a pacemaker capacity. We demonstrated that pulmonary veins can host cardiac stem cell niches. Continuous rapid pacing can induce the differentiation of CMPs and ICCs, and CMPs may underlie the pacemaker activity of isolated pulmonary veins.