Abstract:
INTRODUCTION:The mechanisms by which Class IC drugs slow the rate of functional reentrant arrhythmias are not completely understood. We hypothesized that flecainide widens the excitable gap beyond the pivot point of premature turning wavefronts. METHODS AND RESULTS:In eight perfused subepicardial layers of rabbit left ventricle, a linear lesion was made by radiofrequency (RF) ablation parallel to the fiber orientation. One end of the RF lesion was extended by a short incision. Pacing next to the lesion induced a wavefront propagating with a sharp U-turn around the end of the lesion in either the clockwise or counterclockwise direction. A high-density mapping electrode (240 electrodes, 350-microm resolution) was used to record unipolar electrograms at the pivot point. During control, the shortest V1-V2 interval proximal to the pivot point was 162 +/- 12 msec compared with 173 +/- 13 msec distal to the pivot point (difference 11 +/- 8 msec; P < 0.01). After infusion of flecainide 2 mg/L, the shortest V1-V2 interval proximal and distal to the pivot point were 217 +/- 29 msec and 244 +/- 36 msec (difference 27 +/- 16 msec; P < 0.01). Due to the increase in V1-V2 interval at the pivot point, flecainide widened the temporal excitable gap in the returning limb of the turning wavefront from 30 +/- 11 msec to 55 +/- 22 msec (P < 0.01). High-density mapping at the pivot point revealed that this widening of the excitable gap was due to both macroscopic discontinuous conduction and functional conduction block at the pivot point. CONCLUSION:Flecainide widens the excitable gap in the returning limb of premature U-turning wavefronts by causing macroscopic discontinuous conduction and functional conduction block at the pivot point.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Danse PW,Garratt CJ,Allessie MAdoi
10.1046/j.1540-8167.2001.01010.xkeywords:
subject
Has Abstractpub_date
2001-09-01 00:00:00pages
1010-7issue
9eissn
1045-3873issn
1540-8167journal_volume
12pub_type
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journal_title:Journal of cardiovascular electrophysiology
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更新日期:1996-08-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 临床试验,杂志文章,多中心研究
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abstract::In patients with Wolff-Parkinson-White syndrome, right anteroseptal accessory pathways are uncommon and run from the atrium to the ventricle in close anatomic proximity to the normal AV conduction system. Radiofrequency catheter ablation is the first-line therapy for elimination of these accessory pathways. Although t...
journal_title:Journal of cardiovascular electrophysiology
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pub_type: 杂志文章,随机对照试验
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更新日期:2019-02-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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更新日期:2016-09-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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更新日期:1994-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
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更新日期:1998-08-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2012-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-05-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
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更新日期:2010-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1996.tb00484.x
更新日期:1996-11-01 00:00:00
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pub_type: 杂志文章
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