Abstract:
INTRODUCTION:The aim of this study was to determine the atrial defibrillation threshold (ADFT) of a first shock across the standard right atrium (RA) to distal coronary sinus (dCS) configuration followed by a second shock along the atrial septum with a standard sequential waveform (the second shock leading edge equaled the first shock trailing edge) and a balanced sequential waveform (the leading edges of both shocks were equal). METHODS AND RESULTS:In nine sheep atrial fibrillation was induced with acetyl-beta-methylcholine and burst pacing. A catheter was placed with electrodes in the dCS, proximal coronary sinus (pCS), and RA. A J-shaped catheter was positioned with an electrode at Bachmann's bundle (BB) while another catheter was positioned with an electrode in the superior vena cava (SVC). The ADFTs of six single- and dual-pathway configurations were determined with single, standard sequential, or balanced sequential shocks. The ADFT of the RA-->dCS configuration (0.86 +/- 0.27 J, 159 +/- 29 V, 2.42 +/- 0.36 A) was significantly reduced when followed by an SVC-->pCS (0.58 +/- 0.17 J, 112 +/- 20 V, 1.64 +/- 0.39 A) or a BB-->pCS shock (0.64 +/- 0.16 J, 119 +/- 18 V, 1.81 +/- 0.38 A) with standard sequential shocks. With balanced sequential shocks, the peak voltage and current ADFTs were further significantly reduced (85 +/- 11 V and 1.24 +/- 0.21 A for second shock SVC-->pCS, and 93 +/- 13 V and 1.38 +/- 0.27 A for second shock BB-->pCS). CONCLUSION:The ADFT of the standard RA-->dCS shock is significantly reduced when followed by a second shock along the atrial septum delivered between electrodes in the pCS and either SVC or BB and ADFT is further reduced with balanced sequential shocks.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Zheng X,Benser ME,Walcott GP,Smith WM,Ideker REdoi
10.1046/j.1540-8167.2002.00904.xkeywords:
subject
Has Abstractpub_date
2002-09-01 00:00:00pages
904-9issue
9eissn
1045-3873issn
1540-8167journal_volume
13pub_type
杂志文章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
abstract:INTRODUCTION:Two randomized trials (Multicenter Automatic Defibrillator Implantation Trial [MADIT] and Multicenter Unsustained Tachycardia Trial [MUSTT]) suggest that implantable cardioverter defibrillator (ICD) placement is associated with improved survival in patients with coronary artery disease, depressed left vent...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00342.x
更新日期:2002-04-01 00:00:00
abstract:INTRODUCTION:Understanding whether vasovagal syncope is a lifelong disorder might shed insight into its physiology and affect management strategies. Accordingly, we determined the age of the first syncopal spell in adult patients who sought care for syncope. METHODS AND RESULTS:Patients were 42 +/- 18 years old with 6...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1540-8167.2005.00267.x
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Cerebral thromboembolic event (CTE) is a possible complication of pulmonary vein antrum isolation (PVAI). The objective of this study was to report long-term functional and neurocognitive recovery in patients who had a CTE during or within 48 hours of catheter ablation. METHODS AND RESULTS:We screened 3,0...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01650.x
更新日期:2010-04-01 00:00:00
abstract::Epicardial ablation may be required to eliminate ventricular tachycardia (VT) in patients with underlying structural heart disease. The decision to gain epicardial access is frequently based on the suspicion of an epicardial origin for the VT and/or presence of an arrhythmogenic substrate. Epicardial pathology and VT ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/jce.13842
更新日期:2019-03-01 00:00:00
abstract:INTRODUCTION:Hemodynamic collapse precludes extensive catheter mapping to identify focal target regions in many patients with ventricular tachycardia (VT) associated with heart disease. This study tested the feasibility of catheter ablation of poorly tolerated VTs by targeting a region identified during sinus rhythm. ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00734.x
更新日期:2000-01-01 00:00:00
abstract:INTRODUCTION:An early afterdepolarization (EAD)-induced triggered beat is thought to precipitate torsade de pointes (TdP) in the long QT syndrome (LQTS). Previous studies demonstrated the development of EAD activity and dispersion of repolarization under LQT2 (reduced I(Kr)) and LQT3 (augmented late I(Na)), but not LQT...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00342.x
更新日期:2000-04-01 00:00:00
abstract:INTRODUCTION:Atrial fibrillation (AF) may occasionally affect athletes by impairing their ability to compete, and leading to noneligibility at prequalification screening. The impact of catheter ablation (CA) in restoring full competitive activity of athletes affected by AF is not known. The aim of our study was to inve...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2007.01077.x
更新日期:2008-05-01 00:00:00
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
abstract:INTRODUCTION:Functional tricuspid regurgitation (TR) remains a challenging clinical problem with poor outcomes and few effective treatments. Atrial fibrillation (AF) has been associated with functional TR. We sought to determine whether restoring sinus rhythm through catheter ablation of AF can decrease the degree of T...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14707
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Transseptal access for large sheaths may be encumbered by tissue resistance against the sheath-dilator stepped interface. The ExpanSure Large Access Transseptal Dilator (Baylis Medical) is designed as a single introducer and dilation device with a smooth sheath-dilator transition to support transseptal punct...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14903
更新日期:2021-01-21 00:00:00
abstract:INTRODUCTION:Atrial arrhythmias, including atrial flutter, are common in orthotopic heart transplant recipients. However, only a small number of individual case reports describe the electrical circuit and catheter ablation of atrial flutter after heart transplantation. METHODS AND RESULTS:Detailed electrophysiologic e...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.04440.x
更新日期:2004-12-01 00:00:00
abstract::We report a case in which endocardial radiofrequency (RF) ablation guided by unipolar intracoronary mapping using a guidewire was an effective therapy for treating VT originating from an epicardial site of the left ventricle. A 55-year-old man with dilated cardiomyopathy was referred for treatment of refractory sustai...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00357.x
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Mitral stenosis (MS) has the highest incidence of atrial fibrillation (AF) in chronic rheumatic valvular disease. There are very few studies in isolated MS comparing histopathological changes in patients with sinus rhythm (SR) and AF. OBJECTIVES:To analyze the histological changes associated with isolated M...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13024
更新日期:2016-09-01 00:00:00
abstract:INTRODUCTION:Determination of the optimal electrode configuration during implantable cardioverter defibrillator (ICD) implantation remains largely an empirical process. This study investigated the feasibility of using a finite element model of the thorax to predict clinical defibrillation metrics for internal defibrill...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb00822.x
更新日期:1997-05-01 00:00:00
abstract:INTRODUCTION:Ventricular arrhythmias are a common feature in patients with mitral valve prolapse. In an attempt to determine the origin and underlying electrophysiologic mechanism, we describe a patient with ventricular fibrillation, exercise-induced ventricular tachycardia (VT), and, at the time of diagnosis, prolapse...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb00793.x
更新日期:1997-03-01 00:00:00
abstract::There is an increasing need for invasive electrophysiologists to appreciate the exact anatomy of the epicardial space and the coronary veins. The location of the epicardial fat, the complementary relationship with the main cardiac veins, and the location of sensitive structures (arteries, phrenic nerve, esophagus) hav...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2010.01872.x
更新日期:2010-12-01 00:00:00
abstract::Calcium/calmodulin-dependent kinase II (CaMKII) is a multifunctional serine/threonine kinase widely distributed in a number of tissue types. Activation of CaMKII has been linked to important downstream physiological processes, including apoptosis, hypertrophy, and arrhythmia in the heart. Pharmacological or genetic in...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01295.x
更新日期:2008-12-01 00:00:00
abstract:INTRODUCTION:The degree of organization in ventricular fibrillation (VF) is not known. As an objective measurement of spatial order, spatial correlation functions and their characteristic lengths were estimated from epicardial electrograms of pigs in VF. METHODS AND RESULTS:VF was induced by premature stimulation in f...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1993.tb01242.x
更新日期:1993-10-01 00:00:00
abstract:INTRODUCTION:The success of pulmonary vein isolation (PVI) for atrial fibrillation (AF) may be improved if stable AF sources identified by Focal Impulse and Rotor Mapping (FIRM) are also eliminated. The long-term results of this approach are unclear outside the centers where FIRM was developed; thus, we assessed outcom...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
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更新日期:2014-09-01 00:00:00
abstract::Despite preserved left ventricular function, exercise capacity is often impaired after cardiac transplantation due to autonomic denervation of the donor's sinus node. We present our experience with atrio-atrial resynchronization in 2 pediatric heart transplant recipients. Both were highly active, suffered from chronot...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01678.x
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Lifestyle and risk factor management may improve outcomes in patients with atrial fibrillation (AF). We aim to evaluate the prevalence of modifiable risk factors and how these factors impact clinical outcomes in patients with AF. METHODS AND RESULTS:Data on 17 898 AF cohort patients with AF enrolled between...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
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更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Interrupted inferior vena cava (IVC) is a rare venous anomaly that complicates the treatment of patients who require electrophysiology (EP) procedures. METHODS:We describe five consecutive cases of patients with interrupted IVC who presented to the EP laboratory requiring interventional procedures including...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14421
更新日期:2020-05-01 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:Recent defibrillation studies show that electric fields interact with reentrant activity in myocardial tissue through virtual electrode polarization (VEP). This study focuses on determining how VEP relates to the creation and survival of postshock phase singularities in cardiac tissue and demonstrating tha...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00672.x
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:We prospectively compared the efficacy, safety, and quality of life (QoL) impact of catheter ablation versus antiarrhythmic drugs (AAD) in elderly patients with persistent atrial fibrillation (AF). METHODS AND RESULTS:Four hundred and twelve consecutive patients, aged ≥ 70 years, underwent ablation (Group A...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/jce.12126
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Bundle branch reentry (BBR) typically occurs in patients with dilated cardiomyopathy and infra-Hisian conduction system disease. The macroreentrant circuit of BBR is confined to the His-Purkinje system (HPS) and ventricular myocardium. As such, the atrioventricular (AV) node plays no role in the tachycardi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1995.tb00414.x
更新日期:1995-05-01 00:00:00
abstract:INTRODUCTION:Oral anticoagulation (OAC) based on estimated stroke risk is recommended following catheter ablation (CA) of atrial fibrillation (AF), regardless of the extent of arrhythmia control. However, discontinuing OAC in selected patients may be safe. We sought to evaluate a strategy of OAC discontinuation followi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14864
更新日期:2020-12-31 00:00:00
abstract::We describe a case of symptomatic pseudo-AV block due to His-bundle parasystole masquerading as exercise-induced 2:1 AV block. Electrophysiologic study revealed the presence of His-bundle parasystole, and the fluctuation of parasystolic cycle length could be explained by the concept of modulated parasystole. Modulated...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00965.x
更新日期:2001-08-01 00:00:00
abstract:INTRODUCTION:Due to the lack of good molecular markers, for decades the morphogenetic origin of the cardiac conduction system has been a matter of debate. More recently, the spatial expression of minK-lacZ in the adult mouse heart has been shown, for the larger part, to be coincident with the conduction tissues. METHO...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2003.02467.x
更新日期:2003-04-01 00:00:00