Abstract:
INTRODUCTION:Two hypotheses have been proposed to explain the mechanisms of vulnerability and related failure of defibrillation therapy: the cross-field-induced critical point hypothesis and the virtual electrode-induced phase singularity hypothesis. These two hypotheses predict the opposite effect of preshock repolarization on the chirality (direction of rotation) of shock-induced reentry. The former suggests its reversal upon reversal of repolarization, whereas the latter suggests its preservation. The aim of this study was to determine, by reversing the repolarization sequence, which of the mechanisms is responsible for internal shock-induced arrhythmia in the Langendorff-perfused rabbit heart. METHODS AND RESULTS:We used high-resolution optical mapping to assess the chirality of postshock reentry in 11 hearts. Hearts were paced at a coupling interval of 300 msec at various sites around the field of view (13.5 x 13.5 to 16.5 x 16.5 mm). Cathodal monophasic implantable cardioverter defibrillator shocks (-100 V, 8 msec) were applied during the T wave from a 10-mm coil electrode placed into the right ventricular cavity. We used 3.5 +/- 0.8 different pacing sites per heart. Change in direction of repolarization did not result in change of chirality. Chirality was constant in all 11 hearts despite the complete reversal of activation and repolarization patterns. However, the position of resulting vortices depended on transmembrane polarization gradient inverted delta Vm and amplitude of negative polarization Vm (deexcitation). Stronger gradients and deexcitation produced earlier epicardial break excitation (P = 0.04 and P < 0.0001, respectively). CONCLUSION:Virtual electrode-induced phase singularity mechanism underlies internal shock-induced arrhythmia in this model.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Cheng Y,Nikolski V,Efimov IRdoi
10.1111/j.1540-8167.2000.tb00172.xkeywords:
subject
Has Abstractpub_date
2000-09-01 00:00:00pages
998-1007issue
9eissn
1045-3873issn
1540-8167journal_volume
11pub_type
杂志文章abstract:INTRODUCTION:In isolated rabbit hearts, repetitive endocardial focal discharges (REFDs) were consistently observed during ventricular fibrillation (VF) with prolonged (>5 minutes) global ischemia (GI). We hypothesized that BAPTA-AM, a calcium chelator, can suppress these REFDs. METHODS AND RESULTS:Using a two-camera o...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02067.x
更新日期:2011-10-01 00:00:00
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doi:10.1111/j.1540-8167.2009.01650.x
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION:The stability of implantable cardiac defibrillation lead impedance subsequent to implantation has not been reported and may have important clinical implications. The objective was to characterize the incidence and degree of impedance changes occurring after implantation of defibrillation lead systems. MET...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1996.tb00577.x
更新日期:1996-08-01 00:00:00
abstract:INTRODUCTION:Pulmonary vein potentials reflect depolarization of muscle fascicles within the myocardial sleeves that surround the pulmonary veins. The response of pulmonary vein potentials to premature stimulation has not been described. METHODS AND RESULTS:In 31 patients with paroxysmal atrial fibrillation referred f...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2002.00033.x
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:The prognostic value of programmed electrical stimulation (PES) in Brugada syndrome (BrS) remains controversial. Asymptomatic BrS patients generally have a better prognosis than those with symptoms. The purpose of this study was to evaluate the value of nonaggressive PES with up to two extra stimuli and pred...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14848
更新日期:2020-12-25 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12820
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to record the ECG of the smallest living mammal to extend the domain of data for comparative AV nodal electrophysiologic purposes. These data are needed to establish the relationship between the PR interval and heart size in mammalian species of all sizes. METHODS AND RESUL...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00658.x
更新日期:1999-02-01 00:00:00
abstract:INTRODUCTION:Beta-blockers are widely used to prevent the lethal cardiac events associated with the long QT syndrome (LQTS), especially in KCNQ1-related LQTS (LQT1) patients. Some LQT1 patients, however, are refractory to this therapy. METHODS AND RESULTS:Eighteen symptomatic LQTS patients (12 families) were genetical...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.03212.x
更新日期:2004-02-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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更新日期:2020-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02129.x
更新日期:2011-12-01 00:00:00
abstract::This article reviews current evidence of non-antiarrhythmic agents for the prevention and maintenance of sinus rhythm in patients with atrial fibrillation. These nontraditional agents include angiotensin converting enzyme inhibitors, angiotensin receptor blockers, antiinflammatory agents, calcium channel blockers, and...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2007.00874.x
更新日期:2007-11-01 00:00:00
abstract:INTRODUCTION:Endpoints confirming block in the critical isthmus in sinus rhythm and with pace mapping have not been established. METHODS AND RESULTS:A 44-year-old man with a history of Tetralogy of Fallot presented with recurrent ventricular tachycardia (VT). Entrainment mapping was consistent with a macroreentrant ci...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01596.x
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Ablative therapy for atrial fibrillation (AF) by targeting initiating triggers, usually in or around the pulmonary veins, has been reported by several centers. Evidence for an overall improvement in quality of life (QOL) and amelioration of symptoms is lacking. METHODS AND RESULTS:Seventy-one patients und...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00900.x
更新日期:2001-08-01 00:00:00
abstract::A case of iterative atrial tachycardia leading to dilated cardiomyopathy is reported. During electrophysiologic study, the tachycardia showed a markedly irregular cycle length associated with changes in atrial activation breakthrough as demonstrated by coronary sinus (CS) recordings and frequently degenerated into sel...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.01187.x
更新日期:2001-10-01 00:00:00
abstract::About one fifth of all deaths occur suddenly and unexpectedly, often as the first manifestation of heart disease. Several tests have been developed during the past 2 decades for risk stratification of such an event, but only a minority of victims can be identified as being at high risk before sudden death occurs. Impr...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.14.ss9.1.x
更新日期:2003-09-01 00:00:00
abstract:INTRODUCTION:Radiofrequency ablation (RFCA) of ventricular tachycardia (VT) is a potential curative treatment modality. We evaluated the results of RFCA in patients with VT. METHODS AND RESULTS:One hundred fifty-one consecutive patients (122 men and 29 women; age 57 +/- 16 years) with drug-refractory VT were treated. ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00417.x
更新日期:2002-05-01 00:00:00
abstract:INTRODUCTION:This study was designed to analyze dynamic changes in autonomic tone preceding the onset of sustained atrial arrhythmias in patients with focal atrial fibrillation (AF) to determine why patients with frequent discharge from the arrhythmogenic foci develop sustained AF. METHODS AND RESULTS:Holter tapes fro...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00285.x
更新日期:2001-03-01 00:00:00
abstract:INTRODUCTION:The value of noninvasive markers reflecting repolarization and/or conduction abnormalities in identifying patients with abnormal ECG showing a pattern of atypical right bundle branch block and ST elevation syndrome (Brugada syndrome) at risk for life-threatening arrhythmias is controversial. Because right ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00742.x
更新日期:2002-08-01 00:00:00
abstract:INTRODUCTION:Significant species-, tissue-, and age-dependent differences have been described for the L-type calcium current (ICa). Therefore, extrapolation of data obtained from the many animal models to human cardiac physiology is difficult. In this study, we have characterized the voltage-dependent properties of ICa...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1993.tb01281.x
更新日期:1993-08-01 00:00:00
abstract:INTRODUCTION:Atrial fibrillation (AF) is the most frequent arrhythmia seen in clinical practice. Until recently, antiarrhythmic medications have been the only commonly employed treatment for maintaining sinus rhythm. However, antiarrhythmic medications have a modest long-term efficacy and the potential for serious side...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究,评审
doi:10.1111/j.1540-8167.2008.01285.x
更新日期:2009-02-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/jce.12739
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Stroke risk is a significant concern in patients with atrial fibrillation (AF). Low stroke risk patients (CHADS2 VASc 0-2) are often treated long-term with aspirin after catheter ablation. Defining the long-term risks versus benefits of aspirin therapy, after an ablation, is essential to validate this common...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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更新日期:2017-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00897.x
更新日期:1998-02-01 00:00:00
abstract::Similar to the surgical mini-maze procedure, the posterior "box" lesion set employs linear ablation lesions along the anterior aspects of both sets of PVs connected by a roof line and an inferior line to electrically isolate the PVs and complete posterior LA wall en masse. However, creating fully transmural linear atr...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.00944.x
更新日期:2008-03-01 00:00:00
abstract::We present two cases of successful cardioversion of atrial fibrillation using intravenous ibutilide during pregnancy. One patient had atrial fibrillation, complicating the Wolff-Parkinson-White syndrome and the other had a history of nonobstructive hypertrophic cardiomyopathy. No adverse maternal or fetal effects were...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00752.x
更新日期:2007-05-01 00:00:00
abstract::Atrial arrhythmias are quite common in patients after heart transplantation; they can occur via focal or reentrant mechanisms and are amenable to curative therapy with catheter ablation. Integration of the individual patient's surgical anatomy with the arrhythmia pattern on 12-lead electrocardiogram can help both to n...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02106.x
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The presence of heart failure (HF) has been associated with poorer outcomes in patients undergoing catheter ablation (CA) for atrial fibrillation (AF). However, the effectiveness of CA amongst the subset of patients with tachycardia-induced cardiomyopathy (TIC) remains poorly defined. METHODS AND RESULTS:In...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14144
更新日期:2019-11-01 00:00:00
abstract:INTRODUCTION:Isoproterenol is used to assess and facilitate AV nodal conduction, and thus potentiate the induction of supraventricular arrhythmias. It is commonly administered in increasing doses until a predetermined decrease in sinus cycle length, usually 20% to 30%, occurs. This regimen may result in undesirable sid...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb00845.x
更新日期:1997-08-01 00:00:00
abstract:INTRODUCTION:Epicardial catheter ablation is increasingly used to treat arrhythmias with an epicardial component. Nevertheless, percutaneous epicardial access remains associated with a significant risk of major complications. Developing a technology capable of confirming proper placement within the pericardial space co...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13325
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:Catheter ablation of atrial fibrillation (AF) currently relies on eliminating triggers, and no reliable method exists to map the arrhythmia itself to identify ablation targets. The aim of this multicenter study was to define the use of Focal Impulse and Rotor Modulation (FIRM) for identifying ablation targ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/jce.12000
更新日期:2012-12-01 00:00:00