High Uniformity of Left and Right Ventricular Repolarization Dynamics Induced by an Abrupt Decrease in Pacing Cycle Length in a Dog is not Affected by Left Ventricular Ischemia

Leerssen, M B S Hendrik; Vos, Marc A.; Houben, Bert; Dulk, Karel den; Wellens, Hein J.J.

doi:10.1111/j.1540-8167.2000.tb00337.x

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…In this study, MAP was recorded during sinus rhythm and, therefore, the heart rate variability might have influenced the MAP duration and consequently the repolarization sequence 20 , 22 . However, the authors used the heart rate stability monitor feature of the CARTO system and sampled only the MAPs with cycle length change <10% of the initial recordings.…”

Section: Study Limitationsmentioning

confidence: 99%

Global Repolarization Sequence of the Right Atrium:

Hertervig

Kongstad

et al. 2003

Pacing Clinical Electrophis

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The aim of the study was to explore the global sequence of atrial repolarization and its correlation to that of activation. Endocardial monophasic action potentials (MAPs) were sequentially recorded from 51 +/- 14 sites in the right atrium of ten healthy pigs using the CARTO electroanatomic mapping system. Local activation time (AT), MAP duration, and 90% repolarization time (RT) were obtained, and from these data, color coded three-dimensional maps of AT and RT sequences and spatial distribution of MAP duration were reconstructed. The results of the study were: (1) An activation sequence was recognizable in all maps, starting from the posterosuperior wall and ending in the posteroinferior wall near the tricuspid annulus. (2) The repolarization sequence was also recognizable in all maps, and mainly followed the sequence of activation. (3) A significant positive correlation between the RT and AT was observed in all maps with an average r value being 0.571 +/- 0.159 (P < 0.01 - 0.0001), suggesting that progressively later AT associates with progressively longer RT. (4) No consistent correlation between the MAP duration and AT was found. In conclusion, repolarization gradients exist over the atrial endocardium in healthy pigs. The repolarization sequence follows the same sequence as the activation, suggesting that the spatiotemporal pattern of activation is an important determinant of the characteristics of the repolarization sequence.

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Section: Study Limitationsmentioning

confidence: 99%

Global Repolarization Sequence of the Right Atrium:

Hertervig

Kongstad

et al. 2003

Pacing Clinical Electrophis

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Opstal

Verduyn

Winckels

et al. 2002

Journal of Interventional Cardiac Electrophysiology

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Ischemia, Heart Rate, and Ventricular Repolarization

Janse¹

2000

Cardiovasc electrophysiol

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George Ralph Mines was probably the first to note that, after an abrupt change in heart rate, several beats were needed before the ECG attained a constant form. He considered this an interesting example of how “the previous history of the tissue may influence its immediate behaviour.”1 Later studies confirmed that the heart has a long “memory,” that changes brought about by transient changes in rate or rhythm persist for many beats, and that, on a sudden change in heart rate, several hundred beats at the new rate are needed for the refractory period to reach a steady state.2,3 Although in many studies the changes in action potential configuration during acute ischemia have been described (for references see Wit and Janse4), studies on the dynamic behavior of action potential duration and refractory period after sudden changes in heart rate in acutely ischemic myocardium are rare; therefore, the article by Leerssen et al.5 in this issue of Journal is a welcome addition.

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High Uniformity of Left and Right Ventricular Repolarization Dynamics Induced by an Abrupt Decrease in Pacing Cycle Length in a Dog is not Affected by Left Ventricular Ischemia

Abstract: There is a pronounced difference in APD shortening dynamics induced by an abrupt decrease in PCL compared with ischemia. LV shortening dynamics induced by a decrease in PCL are not affected by LV ischemia, preserving a high interventricular uniformity of repolarization dynamics.

Cited by 3 publications

References 33 publications

Global Repolarization Sequence of the Right Atrium:

Global Repolarization Sequence of the Right Atrium:

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Ischemia, Heart Rate, and Ventricular Repolarization

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