Abstract:
OBJECTIVE:The objective of this study was to test the hypothesis that on the epicardium of the in vivo human heart, ventricular fibrillation (VF) consists of chaotic small wavefronts that constantly change paths. BACKGROUND:Despite the significance of VF to cardiovascular mortality, little is known about the wavefronts that constitute VF in humans. METHODS:In 9 patients undergoing cardiac surgery, a single VF episode was induced by rapid pacing immediately after institution of cardiopulmonary bypass while recordings were made from 504 electrodes spaced 2 mm apart in a 20 cm(2) plaque held against the anterior left ventricle epicardium. A total of 26 segments of VF, each 2 s long, were analyzed. A computer algorithm identified individual wavefronts and classified them into groups that followed similar activation sequences. RESULTS:The mean activation rate was 5.8 +/- 1.8 (mean +/- SD) cycles/s. The wavefronts during each epoch were grouped into 9.4 +/- 7.1 different activation pathways, and 8.3 +/- 2.3 wavefronts followed each pathway. Individual wavefronts spread to activate an area of 5.1 +/- 3.0 cm(2) in the mapped region. The majority of the wavefronts propagated into the mapped region and/or propagated out of the mapped region into adjacent tissue, suggesting that the wavefronts were larger than 5.1 cm(2). Reentry was identified in only 16 of the 26 (62%) 2-s segments, always completed <2 cycles, and lasted for 9.5 +/- 6.6% of these 16 epochs, which is 5.8% of the total duration of all the segments analyzed. CONCLUSION:VF wavefronts on the human epicardium are usually large, repeatedly follow distinct pathways, and only occasionally reenter. If these results for the left ventricular epicardium are representative of those for the entire ventricular mass, they do not support the hypothesis that human VF consists of small, constantly changing wavefronts, but rather suggest that there is significant organization of human VF.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Nanthakumar K,Walcott GP,Melnick S,Rogers JM,Kay MW,Smith WM,Ideker RE,Holman Wdoi
10.1016/j.hrthm.2004.01.007keywords:
subject
Has Abstractpub_date
2004-05-01 00:00:00pages
14-23issue
1eissn
1547-5271issn
1556-3871pii
S1547527104000220journal_volume
1pub_type
杂志文章相关文献
HEART RHYTHM文献大全abstract:BACKGROUND:Bidirectional ventricular tachycardia (BVT), which is characterized by an alternating beat-to-beat ECG QRS axis, is a rare but intriguing arrhythmia associated with digitalis toxicity, familial catecholaminergic polymorphic ventricular tachycardia (CPVT), and several other conditions that predispose cardiac ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.11.038
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Pulmonary vein (PV) isolation has become the mainstay acute procedural end point for paroxysmal atrial fibrillation (AF) ablation. OBJECTIVE:To examine the incidence of conduction recovery in the PVs in patients without clinical recurrence of AF after paroxysmal AF ablation. METHODS:From August 2008 to Mar...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.03.015
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The mechanism of bundle branch reentrant tachycardia has been described, and ablation of the right bundle branch (RBB) is a curative approach. OBJECTIVE:The purpose of this study was to evaluate the left bundle branch (LBB)-Purkinje system during sinus rhythm and to test the feasibility of ablating the LBB ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2008.09.028
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Recognition of the creation of transmural lesions (TLs) during atrial ablation procedures is important. OBJECTIVE:The purpose of this study was to characterize local unipolar electrograms (UEs) and bipolar electrograms (BEs) recorded from a TL at different catheter orientations. METHODS:In 13 porcines, 125...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.06.014
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The function of the Purkinje system (PS) is to ensure fast and uniform activation of the heart. Although this vital role during sinus rhythm is well understood, this is not the case when shocks are applied to the heart, especially in the case of failed defibrillation. The PS activates differently from the my...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2009.08.023
更新日期:2009-12-01 00:00:00
abstract::The absence of strategies to consistently and effectively address nonparoxysmal atrial fibrillation by nonpharmacological interventions has represented a long-standing treatment gap. A combined epicardial/endocardial ablation strategy, the hybrid Convergent procedure, was developed in response to this clinical need. A...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.10.004
更新日期:2020-10-09 00:00:00
abstract::Newer generations of pacemakers and implantable cardioverter defibrillators have enhanced diagnostic features that permit detection and storage of information about the frequency, duration, time of onset, and rate characteristics of multiple consecutive episodes of atrial tachycardia and atrial fibrillation (AF). Para...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2004.03.075
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Focal impulse and rotor modulation (FIRM) has been proposed as a novel approach for the treatment of atrial fibrillation (AF). OBJECTIVE:This study aimed to investigate the efficacy of FIRM as a stand-alone procedure for the treatment of paroxysmal AF. METHODS:A total of 27 patients with paroxysmal AF unde...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2016.04.016
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Epicardial pacing increases risk of ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) when pacing in proximity to scar. Endocardial pacing may be less arrhythmogenic as it preserves the physiological sequences of activation and repolarization. OBJECTIVE:The purpose of this study wa...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.03.021
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Detection of atrial repolarization waves free of far-field signal contamination by ventricular activation would allow investigation of atrial electrophysiology and factors that influence susceptibility to atrial tachycardia and atrial fibrillation (AF). OBJECTIVE:The purpose of this study was to identify me...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.11.019
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:The purpose of this study was to characterize the association between the extent of left atrial electroanatomic remodeling in atrial fibrillation and the atrial fibrillation cycle length derived from lead V₁ of the surface ECG (V1AFCL). METHODS:Twenty-three patients in atrial fibrillation (AF) who...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.12.034
更新日期:2014-04-01 00:00:00
abstract::Idiopathic ventricular arrhythmias may arise from anywhere in the heart, and the majority of them can be effectively treated with catheter ablation. The 12-lead electrocardiogram (ECG) is the initial mapping tool to predict the most likely site of origin and is valuable to choose the appropriate ablation strategy. Cru...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2019.04.002
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The extent of left atrial (LA) late gadolinium enhancement (LGE), as a surrogate for fibrosis, has been associated with atrial fibrillation (AF) recurrence after catheter ablation. Furthermore, there is ex vivo evidence that islands of fibrosis may anchor fibrillatory rotors. OBJECTIVE:The purpose of this s...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.11.011
更新日期:2016-03-01 00:00:00
abstract::Cardiac resynchronization therapy (CRT) is an electrical treatment of heart failure with reduced ejection fraction and wide QRS. It aims to correct the electrical dyssynchrony present in 30% to 50% of patients in this population. Dyssynchrony results in widening of the QRS complex on the electrocardiogram (ECG). CRT w...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2015.01.023
更新日期:2015-05-01 00:00:00
abstract::Ventricular fibrillation (VF), despite its declining incidence as a cause of sudden cardiac death, is still a major health problem. The underlying mechanisms for the maintenance of VF are still disputed. Studies suggest that VF is unlikely one static mechanism but rather a dynamic process of electrical derangement tha...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2008.11.005
更新日期:2009-03-01 00:00:00
abstract::Antitachycardia pacing (ATP) strategies represent safe, effective, and painless therapy for ventricular tachyarrhythmias, with a large body of clinical evidence supporting their routine use in both primary and secondary implantable cardioverter-defibrillator recipients. This article details the evidence supporting the...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.02.024
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to assess the long-term effects of ablation of infarct-related ventricular tachycardia (VT) and the subsequent requirement for implantable cardioverter-defibrillator (ICD) therapy. BACKGROUND:The long-term consequences after initially successful catheter ablation of infarct-rel...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2005.01.017
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Despite isolated reports of Brugada syndrome (BrS) in the inferior or lateral leads, the prevalence and prognostic value of ST elevation in the peripheral electrocardiographic (ECG) leads in patients with BrS remain poorly known. OBJECTIVE:To study the prevalence, characteristics, and prognostic value of ty...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2013.03.001
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Mutations in SCN5A are rarely found in Thai patients with Brugada syndrome (BrS). Recent evidence suggested that common genetic variations may underlie BrS in a complex inheritance model. OBJECTIVE:The purpose of this study was to find common and rare/low-frequency genetic variants predisposing to BrS in pe...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.06.027
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Enhanced dispersion of action potential duration (APD) is a major contributor to long QT syndrome (LQTS)-related arrhythmias. OBJECTIVE:To investigate spatial correlations of regional heterogeneities in cardiac repolarization and mechanical function in LQTS. METHODS:Female transgenic LQTS type 2 (LQT2; n =...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.07.038
更新日期:2013-10-01 00:00:00
abstract::The autonomic nervous system is known to play a significant role in the genesis and maintenance of arrhythmias. Neuromodulation, mostly designed to increase the parasympathetic tone and suppress the sympathetic tone, has become an emerging therapeutic strategy for the treatment of arrhythmias. Emerging therapeutic app...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2015.10.001
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Transvenous left ventricular (LV) lead placement for cardiac resynchronization therapy-defibrillator (CRT-D) delivery is unsuccessful in 8% to 10% of cases. These patients might benefit from an epicardial lead. However, data on long-term epicardial lead performance are scarce. Furthermore, extracting an epic...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.11.004
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Once chamber geometry is determined, the EnSite 3000 noncontact mapping system can create a voltage map during a single cardiac cycle. The EnSite uses an inverse solution to the Laplace equation to process the amplified far-field signals from the noncontact catheter. This process creates a three-dimensional ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.10.026
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Concern exists regarding the potential electromagnetic interaction between pacemakers, implantable cardioverter-defibrillators (ICDs) and digital music players (DMPs). A preliminary study reported interference in 50% of patients whose devices were interrogated near Apple iPods. OBJECTIVE:Given the high prev...
journal_title:Heart rhythm
pub_type: 临床试验,杂志文章
doi:10.1016/j.hrthm.2008.02.033
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Arterial hypertension (HT) contributes to progression of atrial fibrillation (AF) via unknown mechanisms. OBJECTIVE:We aimed to characterize electrical and structural changes accounting for increased AF stability in a large animal model of rapid atrial pacing (RAP)-induced AF combined with desoxycorticoster...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.05.016
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Recent research findings have revealed a key role of oxidative DNA damage in the pathogenesis of atrial fibrillation (AF). Therefore, the circulating oxidative DNA damage marker 8-hydroxy-2'-deoxyguanosine (8-OHdG) may represent a biomarker for staging AF and identifying patients at risk for AF recurrence an...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.09.017
更新日期:2020-10-05 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea (OSA) causes negative tracheal pressure (NTP) and is associated with atrial fibrillation (AF). OBJECTIVE:This study aimed to determine the mechanism of atrial electrophysiological changes during tracheal occlusion with or without applied NTP and to evaluate the role of vagal activati...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.03.053
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Experience with retrieval of the Micra transcatheter pacing system (TPS) is limited because of its relatively newer technology. Although abandonment of the TPS at end of life is recommended, certain situations such as endovascular infection or device embolization warrant retrieval. OBJECTIVE:The purpose of ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.02.008
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:As the population ages, recurrent ventricular tachycardia (VT) is increasingly encountered in elderly patients with ischemic heart disease. Radiofrequency catheter ablation is useful for reducing VT therapy in patients with an implantable defibrillator. The utility of radiofrequency catheter ablation in the ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.02.019
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Little is known about the role of left atrial appendage closure using the Watchman device (Boston Scientific) in patients who are at very high risk for stroke. OBJECTIVE:The purpose of this study was to assess the role of Watchman in patients with CHA2DS2-VASc ≥5. METHODS:All patients undergoing procedures...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2019.07.011
更新日期:2020-01-01 00:00:00