Intramural Depolarization Potentials in Myocardial Infarction

Prinzmetal, Myron; Kennamer, S. Rexford; Shaw, Clinton McK.; Kimura, Noboru; Lindgren, Inga; Goldman, Alfred

doi:10.1161/01.cir.7.1.1

Cited by 53 publications

(5 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, this level must contribute to the surface potentials, both of the heart and the torso, and cannot be considered "silent." This finding is contrary to the conclusions of other workers (11)(12)(13). The contribution of the inner levels, particularly in dogs, would be expected to be less than the outer levels, however, since they exhibited significantly smaller voltages.…”

Section: Analysis Of Variance For Propagation Time Differencescontrasting

confidence: 93%

“…Prinzmetal et al (13) and Sodi-Pallares et al (9) particularly, argue from this point and from the morphology of intramyocardial waveforms that these regions do not contribute to a surface ECG. Additional evidence obtained from induced infarct data (13) indicates that infarcts in these inner areas do not produce discernible changes in epicardial and body surface electrical potential measurements. Durrer and co-workers (14, 15) took a contradictory position and argued that the inner portions of the heart are not electrically silent.…”

Section: Selvester Kirk Pearsonmentioning

confidence: 98%

See 1 more Smart Citation

Propagation Velocities and Voltage Magnitudes in Local Segments of Dog Myocardium

Selvester

Kirk

Pearson

1970

Circulation Research

View full text Add to dashboard Cite

Propagation velocities and differential voltages of the electromotive surface in the left ventricle were measured in dogs by multipoint bipolar intramyocardial electrodes. The average velocity of propagation in the inner 4 mm of the ventricular wall of dogs was 2.0 mm/msec, which is considerably greater than that in the middle (0.70 mm/msec) or the outer 4 mm (0.40 mm/msec). The average voltage was less in the inner levels of the ventricular wall than in the outer, but significantly different from zero. This fact indicates a definite but lesser contribution per unit volume than from the outer levels. The propagation of the electromotive surface through the ventricular wall was consistently from endocardium to epicardium with no significant areas propagated in the reverse direction.These data disagree with the hypothesis that certain levels in the wall of the heart and certain regions of the heart are electrocardiographically silent. In dogs, and to a greater degree in humans, small infarcts anywhere in the heart can be expected to produce significant and discernible changes in surface ECGs. The task remains to refine and validate criteria for the diagnosis of infarct in these areas. When viewed from within the myocardium, the waveforms observed in bipolar intramyocardial electrodes are inconsistent with the dipole layer hypothesis as a model of the electromotive surface of ventricular depolarization in the heart. This investigation was supported in part by U. S. Public Health Service Research Grants HE 09123, HE 10722, and HE 07888 from the National Heart and Lung Institute. ADDITIONAL KEY WORDSReceived October 6, 1967. Accepted for publication August 17, 1970. based embodied the following assumptions: (a) the heart was a distributed set of fixed locus dipoles; (b) the volume conductor was resistive, isotropic, and contained internal inhomogeneities (lungs) and was limited by a normal male adult torso external boundary; (c) the ventricular activation sequence in humans was that reported by Durrer (5) and similar to that recorded in dogs by Scher (6); (d) the wave of depolarization through the ventricles was a current dipole layer; (e) the variation in the velocity of propagation of the wave of depolarization from endocardium to epicardium in the ventricular wall was so minimal that it could be ignored; (f) the electromotive source distribution and strength were always uniform over the entire propagation front.

show abstract

Section: Analysis Of Variance For Propagation Time Differencescontrasting

confidence: 93%

Section: Selvester Kirk Pearsonmentioning

confidence: 98%

Propagation Velocities and Voltage Magnitudes in Local Segments of Dog Myocardium

Selvester

Kirk

Pearson

1970

Circulation Research

View full text Add to dashboard Cite

show abstract

“…En los trazados electrocardiográficos nos han llamado la atención dos cuadros, ambos de anoxh miocárdica, pero de características diferentes: El primero de ellos es similar al del infarto de miocardio, con normalización a los breves minutos, en el que no existía la reciprocidad de los espacios S-T en las derivaciones iJipohres de miembros, pero sí en la müpolar del brazo derecho, que lo interpretamos, a que al estar locali-7,:i,da la zona de lesión •en la región pastero -lateral, se manifestaba en todas las derivaciones bipolares de miembros. Los descensos de los espaci.os S•-T en aVF, V4 y V5 inmediatamente cedida la crisis de dolor, los consideramos similares a los encontrados por Prinzmetal en sus traba-jos experimentales (15,17), in-~-1edi9.tamente de soltar la liga.dura de la arteria coronaria, ya que suprmemos que, de haberse podido :•ecoger la crisis de dolor durante todo el trazado, hubiésemos observado probablemente elevaciones de los e~ pacios S-T en aVF, V4 y V5.…”

Section: Comentariosunclassified

“…Prinzmetal y col. (15,16,17) señ2 ... lan cómo diferentes grados de isqueml.a pueden manifestarse con cuadros el'?ctrocardiográficos diferentes, señalando dos tipos de isquemi'l: una severa, como en los casos d2 infarto de miocardio y en la forrr a inversa de angina de peci:to, y otra ele mediana intensidad, como en la angina clásica e infarto sub -endocárdico. Ha practicado una serie de experimentos hemodinámi.cos, bioeléctrícos y metabólicos en los qu¡o Vol.…”

Section: Comentariosunclassified

Forma variante de la angina de pecho.

Sagués

2017

revista-de-medicina

View full text Add to dashboard Cite

Se presenta un caso de angina de pecho atípica, semejante a los descritos por Prinzmetal y colaboradores, en el que las crisis de dolor retroesternal se presentaban en reposo o durante una actividad ordinaria y nunca con el esfuerzo, que el enfermo lo practicaba para convencerse de que no padecía una insuficiencia coronaria. Se registran los trazados electrocardiográficos durante la crisis de angor atípico y después de la prueba de esfuerzo, que presentan alteraciones de los espacios ST con características diferentes. El enfermo con posterioridad presentó una necrosis miocárdica con la misma localización que la que presentaba durante la crisis de angor atípico. Se discuten las alteraciones apreciadas en estos cuadros y fa necesidad, en muchos casos, de registrar el electrocardiograma durante las crisis de dolor.

show abstract

“…Although the measured time values do not eliminate the possibility of some more superficial type of rapid, parallel-fiber conduction, 13 evidence has been obtained that excitation of the homolateral free ventricular wall during bundle branch block is accomplished by a spread from endocardium to epicardium as occurs in the normal ventricle. 14 It has not been fully appreciated that the mechanisms in incomplete bundle-branch block may be variable and complex. The present studies call attention to the existence of two distinct types of incomplete block.…”

mentioning

confidence: 99%

The Second World Congress of Cardiology

White

1954

Circulation Research

View full text Add to dashboard Cite

Controlled studies of ventricular excitation were performed in dogs exhibiting various degrees of right imd left bundle-branch block. Increases in the intraventricular conduction time during complete bundle-branch block are attributed to free wall as well as septal factors. Incomplete bundle-branch block may be either segmental or diffuse. In the segmental type, delayed excitation is present in only a portion of the involved ventricle. In the diffuse type, delayed excitation of the entire homolateral ventricle occurs, but some portions of the ventricle tend to be delayed to a greater extent than others. Certain segements of the ventricular myocardium appear to be .supplied by fixed portions of the conducting system, without cross connections operating physiologically. The clinical implications of these observations are briefly discussed.

show abstract

Intramural Depolarization Potentials in Myocardial Infarction

Cited by 53 publications

References 9 publications

Propagation Velocities and Voltage Magnitudes in Local Segments of Dog Myocardium

Propagation Velocities and Voltage Magnitudes in Local Segments of Dog Myocardium

Forma variante de la angina de pecho.

The Second World Congress of Cardiology

Contact Info

Product

Resources

About