Abstract:
BACKGROUND:Complex fractionated atrial electrograms have been suggested as important targets for catheter ablation of atrial fibrillation. The etiology and the mechanism of these signals have not been completely elucidated because of limitations of interpretation of these signals in relation to simultaneously acquired signals in the neighboring atrial tissue. OBJECTIVE:This study sought to study the origin of electrogram fractionation under the conditions of rotor formation and wave fragmentation, using atrial monolayer preparations. METHODS:We performed optical mapping of 45 atrial monolayer preparations using a complementary metal oxide semiconductor (CMOS) Brainvision Ultima camera system (SciMedia-Brainvision, Tokyo, Japan). RESULTS:We observed stable rotors in 32 of the 45 recordings. The derived bipolar electrograms did not show complex fractionation at the core of the rotor in any of the 32 recordings. We were also able to show that 2 bipolar electrodes placed adjacent to the core of a stable rotor in a zone where there is no wave break will record electrical activity for the majority of the rotor's cycle length. In 13 of the 45 recordings, wave break or wave collision events were present. Of these, 8 of 13 recordings showed complex fractionation. In 19 of the 27, simulation of meandering rotors also showed complex fractionation. CONCLUSION:Complex fractionated electrograms can be recorded at sites of migrating rotors and wave break. No fractionation occurs at the core of a stable rotor. Electrograms that span the rotor cycle length and alternate between 2 bipoles that straddle the core can identify site of a stable rotor.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Umapathy K,Masse S,Kolodziejska K,Veenhuyzen GD,Chauhan VS,Husain M,Farid T,Downar E,Sevaptsidis E,Nanthakumar Kdoi
10.1016/j.hrthm.2008.03.022subject
Has Abstractpub_date
2008-07-01 00:00:00pages
1029-35issue
7eissn
1547-5271issn
1556-3871pii
S1547-5271(08)00325-1journal_volume
5pub_type
杂志文章相关文献
HEART RHYTHM文献大全abstract::Atrial fibrillation is a marker for worse outcomes in patients with heart failure and requires careful, individualized management. Anticoagulation and rate control are important. Routine use of antiarrhythmic drug therapy for maintenance of sinus rhythm carries concerns of risk and limited efficacy. Catheter ablation ...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2006.12.003
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:The best periprocedural anticoagulation strategy at the time of pulmonary vein isolation (PVI) is not known. Most centers stop administering warfarin (Coumadin) and use bridging with heparin or enoxaparin. OBJECTIVE:The purpose of this study was to evaluate the efficacy and safety of PVI under therapeutic i...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2009.07.007
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Although heart failure (HF) is closely associated with susceptibility to sudden cardiac death (SCD), the mechanisms linking contractile dysfunction to cardiac electrical instability are poorly understood. Cardiac alternans has also been closely associated with SCD, and has been linked to a mechanism for ampl...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2008.11.008
更新日期:2009-02-01 00:00:00
abstract::Among the most serious problems associated with heart failure is the increased likelihood of life-threatening arrhythmias. Both triggered and reentrant arrhythmias in heart failure may arise as a result of aberrant intracellular Ca cycling. This article presents some new ideas, based on recent studies, about how alter...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2011.06.012
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the efficacy of a totally subcutaneous, anteroposterior defibrillation shock pathway using a long time-constant shock waveform that emulates a proposed device having approximately twice the capacitance and thus twice the available energy of traditional transvenous de...
journal_title:Heart rhythm
pub_type: 临床试验,杂志文章
doi:10.1016/j.hrthm.2007.08.030
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Diagnosing long QT syndrome (LQTS) remains challenging because of a considerable overlap in QT interval between patients with LQTS and healthy subjects. Characterizing T-wave morphology might improve LQTS diagnosis. OBJECTIVE:The purpose of this study was to improve LQTS diagnosis by combining new polynomia...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2019.12.020
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The availability of safe and effective drugs for the management of atrial fibrillation (AF) remains an unmet medical need. OBJECTIVES:The purpose of this study was to test the hypothesis that the inhibition of the rapidly activating delayed rectifier potassium current (IKr) greatly potentiates the developme...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.12.033
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Tachycardia-induced cardiomyopathy (TIC) seems to be a form of reversible cardiomyopathy. With recurrence, TIC can be more severe and may increase the risk for sudden cardiac death. OBJECTIVE:We postulate that negative remodeling persists even though ejection fraction (EF) normalizes after appropriate treat...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2008.04.023
更新日期:2008-08-01 00:00:00
abstract::This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy. ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.12.040
更新日期:2010-12-27 00:00:00
abstract::Since the discovery of atrial natriuretic peptide (ANP) in 1981, significant progress has been made in understanding the mechanism of its release and its role in salt and water balance in the body. It has also become clear that ANP plays a key role in cardiac electrophysiology, modulating the autonomic nervous system ...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2011.11.019
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Several mammalian species display distinct biophysical properties between atrial and ventricular voltage-gated sodium current (INa); however, the potential mechanism behind this phenomenon is unknown. OBJECTIVE:The purpose of this study was to investigate the potential molecular identities of the different ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.11.022
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:The early repolarization pattern (ERP) is common and associated with risk of sudden cardiac death. ERP is heritable, and mutations have been described in syndromatic cases. OBJECTIVE:To conduct a meta-analysis of genome-wide association studies to identify common genetic variants influencing ERP. METHODS:W...
journal_title:Heart rhythm
pub_type: 杂志文章,meta分析
doi:10.1016/j.hrthm.2012.06.008
更新日期:2012-10-01 00:00:00
abstract::In 1987, the MAZE procedure was introduced into clinical practice by Dr. James Cox. Prior procedures included AV node ablation and other procedures that had major limitations. The clinical success of the MAZE procedure was over 90% in most series. Adoptability was limited by its technical complexity. With the introduc...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2008.03.029
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:The degree of QT prolongation by drug is highly variable and related to risk for polymorphic ventricular tachycardia due to drugs. OBJECTIVE:The purpose of this study was to determine factors that affect the degree of QT prolongation by drugs. METHODS:QT and QTc were measured before and after administratio...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.03.042
更新日期:2011-10-01 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:BACKGROUND:The role of atrial-based pacing algorithms in preventing atrial fibrillation (AF) remains controversial. The inconsistent results noted in previous trials may be due in part to differences in endpoints, pacing algorithms, and study design. SAFARI, a worldwide, prospective, randomized clinical trial, was desi...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2008.11.033
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Prolongation of the PR interval has been associated with an increased risk of incident atrial fibrillation (AF). OBJECTIVE:To determine if there was a nonlinear relation between PR interval duration and the risk of AF. METHODS:We included 288,181 individuals, corresponding to one third of the population in...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.04.012
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Genetic testing for long QT syndrome (LQTS) has been available in a research setting for the past decade, and a commercial test has recently become available. However, the costs and effectiveness of genetic testing have not been estimated. OBJECTIVES:The purpose of this study was to conduct a cost-effective...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2005.08.026
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Controversy remains regarding the use of cardiac resynchronization therapy (CRT) in patients with heart failure with right bundle branch block (RBBB) and reduced left ventricular (LV) ejection fraction. Moreover, little is known about acute hemodynamic changes with CRT in this subgroup as compared with patie...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2018.05.017
更新日期:2018-10-01 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:The human ether-à-go-go-related gene (hERG 1a) potassium channel is critical for cardiac repolarization. hERG 1b, another variant subunit, co-assembles with hERG 1a, modulates channel biophysical properties and plays an important role in repolarization. Mutations of hERG 1a lead to type 2 long QT syndrome (L...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2016.01.012
更新日期:2016-05-01 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:BACKGROUND:Carvedilol and its analogues suppress delayed afterdepolarizations (DADs) and catecholaminergic polymorphic ventricular tachycardias by direct action on the cardiac ryanodine receptor type 2 (RyR2). OBJECTIVE:To test a hypothesis that carvedilol analogue may also prevent triggered activities (TAs) through t...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2012.09.006
更新日期:2013-01-01 00:00:00
abstract::Safe maneuvering of catheters in and around the ventricles, and ablations for ventricular tachycardia, require knowledge of the anatomy of the cardiac and extracardiac structures. This review emphasises the three-dimensional spatial relationships between the right and left ventricles and highlights the important extra...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2009.02.008
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Complex fractionated atrial electrograms (CFAEs) and regions of high dominant frequency (DF) both may identify sites critical to the maintenance of atrial fibrillation (AF). CFAEs may be defined by either (1) complex multicomponent electrograms (EGMs) and/or continuous electrical activity (multicomponent/con...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.05.021
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:His-bundle pacing (HBP) is a physiological alternative to right ventricular pacing (RVP). The outcomes of HBP in patients with longstanding atrioventricular block (AVB) and RVP are unknown OBJECTIVE: The purpose of this study was to retrospectively assess the feasibility of HBP in patients with chronic RVP a...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2019.03.026
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Membrane-associated guanylate kinase (MAGUK) proteins are important determinants of ion channel organization in the plasma membrane. In the heart, the MAGUK protein SAP97, encoded by the DLG1 gene, interacts with several ion channels via their PDZ domain-binding motif and regulates their function and localiz...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.09.057
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Complex fractionated electrograms (CFAEs) detected during substrate mapping for atrial fibrillation (AF) reflect etiologies that are difficult to separate. Without knowledge of local refractoriness and activation sequence, CFAEs may represent rapid localized activity, disorganized wave collisions, or far-fie...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.10.020
更新日期:2011-02-01 00:00:00
abstract::Despite the increasing number of sophisticated, computerized tools available to the practicing electrophysiologist for facilitating catheter ablation of ventricular tachycardia, the procedure is often quite challenging. Use of these tools needs to be kept in perspective, subservient to the judgment of the physician. T...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2009.02.014
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Persistent atrial fibrillation (AF) is associated with a high risk of recurrence after electrical cardioversion. OBJECTIVE:We examined if long-term supplementation with omega-3 polyunsaturated fatty acids in fish oils commenced >1 month prior to electrical cardioversion and continued thereafter reduces recu...
journal_title:Heart rhythm
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.hrthm.2011.11.034
更新日期:2012-04-01 00:00:00