Abstract:
INTRODUCTION:It is the hypothesis of this article that the onset of fibrillation following a coronary artery occlusion is a direct consequence of the spatial inhomogeneity of chemical processes that occur following the occlusion. In particular, the localized increase of extracellular potassium and decrease of ATP availability lead to an increase of resting potential in the affected cells. This difference in potential between affected cells and normal cells drives a current, the "current of injury," which may drive oscillations in the border zone, a "border zone arrhythmia." The border zone arrhythmia may drive a "breakup instability" (related to the action potential duration restitution instability) in the surrounding tissue, leading to self-sustained fibrillation. METHODS AND RESULTS:In this article, we present a mathematical model demonstrating this transition from normal to fibrillatory dynamics, describing the general conditions under which this transition occurs and showing in a simple ionic model the way in which spatial inhomogeneity alone can initiate self-sustained reentrant activity. CONCLUSION:Using general arguments and numerical simulations with generic models of excitable media, we have demonstrated that a spatial region with an elevated resting potential surrounded by a spatial region wherein action potentials are foreshortened can drive a breakup instability, leading to the rapid initiation of a fibrillatory state.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Keener JPdoi
10.1046/j.1540-8167.2003.03045.xkeywords:
subject
Has Abstractpub_date
2003-11-01 00:00:00pages
1225-32issue
11eissn
1045-3873issn
1540-8167journal_volume
14pub_type
杂志文章abstract:INTRODUCTION:Prevention of sudden arrhythmic cardiac death depends on accurate identification of individuals at high risk. Previous studies of signals recorded directly from arrhythmogenic tissue suggested that the predictive value of the signal-averaged ECG could be enhanced by expanded temporal, spectral, and spatial...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2000.tb00315.x
更新日期:2000-02-01 00:00:00
abstract:INTRODUCTION:The reason for the increased defibrillation efficacy of biphasic shocks over monophasic shock is not definitely known. METHODS AND RESULTS:In six anesthetized pigs, we mapped the epicardium after transvenous defibrillation shocks to compare the activation patterns following successful biphasic shocks with...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1996.tb00533.x
更新日期:1996-04-01 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:INTRODUCTION:Frequent premature ventricular contractions (PVCs) can cause cardiomyopathy (CM). Postextrasystolic potentiation (PESP) and irregularity have been in implicated as triggers of PVC-CM. Because both phenomena can also be found in premature atrial contractions (PACs), it is speculated that frequent PACs have ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14067
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:The aims of this study were to investigate: (1) the effect of supplementing the culture medium on preservation of L-type calcium channel current (1Ca,L) in adult rabbit ventricular myocytes cultured for 4 days; and (2) preservation of the ICa,L response in cultured myocytes to the beta-adrenergic agonist i...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb00626.x
更新日期:1997-09-01 00:00:00
abstract:INTRODUCTION:The incidence of left atrial appendage (LAA) thrombus in patients with paroxysmal atrial fibrillation (PAF) who present for pulmonary vein antrum isolation procedure (PVAI) is unknown. METHODS AND RESULTS:All consecutive patients from January 2000 to June 2004 who underwent a PVAI received a computed tomo...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.01070.x
更新日期:2008-04-01 00:00:00
abstract:INTRODUCTION:Ablation electrode-tissue contact has been shown to be an important determinant of lesion size and safety during nonirrigated ablation but little data are available during irrigated ablation. We aimed to determine the importance of contact force during irrigated-tip ablation. METHODS AND RESULTS:Freshly e...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01693.x
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:The optimal recording technique of the electrogram voltage for detecting abnormal atrial tissue remains unclear. The aim of this study was to compare the impact of various recording techniques on the electrogram voltage after the delivery of ablation therapy in the human right atrium (RA). MATERIAL AND METH...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2007.00803.x
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:We sought to systematically investigate the role of the ligament of Marshall (LOM) and inferior left ganglionated plexi (ILGP) in modulating electrophysiological functions. METHODS:The following structures were exposed in 36 dogs: (1) LOM, (2) superior left GP (SLGP) near the junction of left superior pulmo...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01315.x
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) significantly reduces health-related quality of life (HRQoL), previously measured in clinical trials using patient-reported outcomes (PROs). We examined AF PROs in clinical practice and their association with subsequent clinical management. METHODS:The Utah My Evaluation (mEVAL) pro...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14795
更新日期:2020-12-01 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::Atrial tachyarrhythmias are the most common arrhythmias in the general population. The abundant experimental evidence suggests that the autonomic nervous system plays an important role in the occurrence of atrial arrhythmias. However, complex interactions of the autonomic nervous system with the arrhythmogenic substra...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1046/j.1540-8167.2002.00083.x
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:Atrial arrhythmias have emerged as a topic of great interest for clinical electrophysiologists. Noninvasive imaging of electrical function in humans may be useful for computer-aided diagnosis and treatment of cardiac arrhythmias, which can be accomplished by the fusion of data from ECG mapping and magnetic...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2003.02558.x
更新日期:2003-07-01 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:The advent of signal-averaged ECG (SAECG) systems for P wave analysis has made it important to determine if the use of different filtering techniques in these systems is diagnostically equivalent. METHODS AND RESULTS:Three different high-pass filtering techniques and two cutoff frequency values were used:...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.1998.tb00910.x
更新日期:1998-03-01 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:Pulmonary vein (PV) reconnection is frequent in patients showing atrial fibrillation (AF) recurrence after PV isolation (PVI). Its detection with cardiac magnetic resonance (CMR) may help predict outcome and guide redo procedures. We assessed the relationship between scar on CMR and PV reconnection after c...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13908
更新日期:2019-05-01 00:00:00
abstract:INTRODUCTION:In patients with sinus node disease (SND), the dual-chamber pacemaker (PM) is programmed in DDDR mode with an algorithm to avoid unnecessary right ventricular (RV) pacing. This pacing mode may prolong PR interval with consequently atrioventricular (AV) asynchrony which is associated with a higher risk of a...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14810
更新日期:2020-11-11 00:00:00
abstract:INTRODUCTION:How cell-to-cell electrical coupling influences an antiarrhythmic agent's effect on conduction is largely unknown. To investigate this, we evaluated the effects of procainamide on myocardial conduction at decreasing degrees of cell-to-cell electrical coupling induced by graded doses of heptanol. METHODS A...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb00781.x
更新日期:1997-02-01 00:00:00
abstract:INTRODUCTION:Recent evidence has demonstrated that defibrillation shocks terminate or reset reentrant activity in the myocardium through the generation of virtual electrode polarization (VEP). Previous research has revealed that the shock establishes phase singularities (PSs) in the tissue via the VEP mechanism. The ai...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540.8167.90317.x
更新日期:2003-10-01 00:00:00
abstract::When an implanted device is infected, complete explantation of the device system, including lead extraction, is usually required. Superficial problems with wound healing may be managed more conservatively, but distinguishing between a surface process and deeper infection can pose a clinical challenge. We present a cas...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02224.x
更新日期:2012-03-01 00:00:00
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
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.01415.x
更新日期:2001-12-01 00:00:00
abstract:INTRODUCTION:In patients with permanent pacemakers, mode switching events often are interpreted as surrogate markers for atrial tachyarrhythmias. The aim of this study was to determine the accuracy of automatic mode switching algorithms in patients with permanent pacemakers for the diagnosis of atrial tachyarrhythmias....
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.03537.x
更新日期:2004-07-01 00:00:00
abstract:INTRODUCTION:Vasovagal reflex is the most common type of syncope but its etiology is not fully elucidated. Venous return and cardiac output are key in hemodynamic control. The aim of the study was to assess cardiovascular biomarkers and echocardiographic measures at rest and during hypovolemia in women with and without...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14207
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Perforation during catheter procedures in either the atrium or ventricle is relatively uncommon, but potentially fatal if tamponade ensues. This study analyzes the occurrence and outcomes of cardiac perforation during catheter-based radiofrequency ablation procedures in the left atrium. METHODS:All patients...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.50135.x
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Patients with left bundle branch block (LBBB) undergoing right heart catheterization can develop complete heart block (CHB) or right bundle branch block (RBBB) in response to right bundle branch (RBB) trauma. We hypothesized that LBBB patients with an initial r wave (>or=1 mm) in lead V1 have intact left to ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01714.x
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:While some posteroseptal and left posterior accessory pathways (APs) can be ablated on the tricuspid annulus or within the coronary venous system, others require a left-sided approach. "Fragmented" or double potentials are frequently recorded in the coronary sinus (CS), with a smaller, blunt component from...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2008.01103.x
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Focal atrial tachycardias (FAT) originate from areas with poor cell-to-cell coupling. Due to cellular uncoupling extracellular potentials become fractionated. The degree of fragmentation may be used to identify the site of origin of FAT prior to catheter ablation. We studied electrical fragmentation in relat...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2006.00568.x
更新日期:2006-10-01 00:00:00
abstract::We report the case of a 71-year-old man with two atrial tachycardias evolving simultaneously and independently in two dissociated regions after extensive ablation for chronic atrial fibrillation. One tachycardia was a focal tachycardia originating from the right inferior pulmonary vein and activating the posterior lef...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.01067.x
更新日期:2008-09-01 00:00:00
abstract:INTRODUCTION:The relationship between the determining factors and beating rates of pulmonary vein (PV) pacemaker cardiomyocytes has not been fully elucidated. The purposes of this study were to compare the electrophysiological characteristics between PV fast and slow pacemaker cardiomyocytes. METHODS:Whole-cell patch ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01480.x
更新日期:2009-09-01 00:00:00