The Muscular Reactions of the Mammalian Ventricles to Artificial Surface Stimuli

Wiggers, Carl J.

doi:10.1152/ajplegacy.1925.73.2.346

Cited by 275 publications

(113 citation statements)

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“…It can be expected that such differences in regional electrical activation time and the correlated inhomogeneities in regional fiber shortening result in the deterioration of global left ventricular hemodynamic performance as was also found in other studies [2, 6-8, 13, 18, 20, 22, 30]. The finding that the decrease in hemodynamic performance was most pronounced during pacing from the right ventricular outflow tract is in agreement with the suggestion of Wiggers [31] that the degree of electrical asynchrony is proportional to the contractile strength of the left ventricle.…”

Section: Discussionsupporting

confidence: 91%

Relation between regional electrical activation time and subepicardial fiber strain in the canine left ventricle

et al. 1993

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Abstract.To determine the relation between regional electrical activation time and fiber strain, epicardial electrical activation and deformation were measured in six open-chest dogs at the left ventricular anterior free wall after 15 min of right atrial, left ventricular free wall, left ventricular apex, or right ventricular outflow tract pacing, when end-diastolic pressure was normal or elevated (volume-loading). Regional electrical activation was measured using a 192-electrode brush. Regional subepicardial fiber strain (e0 was measured simultaneously in 16 regions, using optical markers which were attached to the epicardial Surface and recorded on video. When relating regional ef during the ejection phase to regional activation time, the best correlation was found when a hemodynamic time reference rather than an electrophysiological one is used. Using the moment of the maximum rate of change of left ventricular pressure as the time reference for electrical activation, regional electrical activation time (t~,) and the degree of ef during the ejection phase could be fitted by a linear regression equation ee = ate, + b, in which a = -3.46 + 0.73 s -~ and b = -0.28 + 0.05. For electrical activation times ranging from -40 to -80 ms, fiber strain was estimated with an accuracy of _+ 0.026 (_+ SE) with this relation. During right atrial pacing, te, and ee were on the average -48 ms and -0.10 respectively. On further investigation, the relation between ef and t~, appeared to be influenced by end-diastolic pressure. For normal (1.1 kPa) and elevated end-diastolic pressure (1.8 kPa), the slope of the linear regression line was -3.96 and -2.86s -~, respectively. Three conclusions may be drawn. Firstly, the time interval between the moment of regional electrical activation and the moment of the maximum rate of change of left ventricular pressure is an index of regional fiber strain. Secondly, it can be concluded from the above equations that electrical asynchrony of more than 30 ms causes non-uniformities in the degree of ef of the order of mean ef during pacing from the fight atrium. Finally, differences in fiber strainCorrespondence to: R. S. Reneman during asynchronous electrical activation are less pronounced at larger filling pressures.

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Section: Discussionsupporting

confidence: 91%

Relation between regional electrical activation time and subepicardial fiber strain in the canine left ventricle

et al. 1993

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“…Mitral regurgitation would contribute to reduce the volume ejected into the aorta . It has been known that the conduction velocity in ventricular muscle tissue is slower than the velocity in the specialized conducting system (Wiggers 1925) . The abnormal direction of excitation and slower conduction velocity with ventricular stimulation produce a less synchronous ventricular contraction than that resulting from right atrial stimulation (Wiggers 1925;Gilmore et al .…”

Section: Discussionmentioning

confidence: 99%

Effects of Varying Pacemaker Sites on Left Ventricular Performance

Miyazawa

Shirato

Haneda

et al. 1976

Tohoku J. Exp. Med.

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“…The cardiac output is greater during AAI pacing than with dual-pacing DDD. Wigger (1925) showed that ventricular pacing results in reduced ventricular-pump function in mammals. Ventricular desyncronization imposed by pacing results in chronic left ventricular remodeling, including asymmetric hypertrophy and dilatation.…”

Section: Pacemaker Syndromementioning

confidence: 99%