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 amplifying electrical heterogeneities in the heart. However, previous studies have focused on alternans in normal rather than failing myocardium. OBJECTIVE:This study sought to investigate the hypothesis that HF enhances susceptibility to arrhythmogenic cardiac alternans. METHODS:High-resolution transmural optical mapping was performed in canine wedge preparations from normal (n = 8) and HF (n = 8) hearts produced by rapid ventricular pacing. RESULTS:HF significantly (P < .004) lowered the heart rate (HR) threshold for action potential duration alternans (APD-ALT) from 236 +/- 25 beats/min to 185 +/- 25 beats/min. In dual optical mapping of action potentials and intracellular Ca experiments (n = 16), HF lowered the HR threshold for Ca-ALT (beat-to-beat alternations of cellular Ca cycling) from 238 +/- 35 to 177 +/- 26 beats/min (P < .005). Importantly: (1) Ca-ALT always either developed at slower HR or simultaneously with APD-ALT in the same cells, and (2) the magnitude of Ca-ALT and APD-ALT were closely correlated (P < .05). HF similarly lowered the HR threshold for Ca-ALT in isolated myocytes under nonalternating action potential clamp, indicating that HF enhances susceptibility to cellular alternans independent of HF-associated changes in repolarization. Importantly, HF significantly (P < .02) lowered the HR threshold for spatially discordant arrhythmogenic alternans (different regions of cells alternating in opposite phase, DIS-ALT). Ventricular fibrillation (VF) was induced in 88% of HF preparations, but only 12% of normal preparations (P < .003) and was uniformly preceded by development of DIS-ALT. CONCLUSION:Heart failure increases the susceptibility to arrhythmogenic cardiac alternans, which arises from HF-induced impairment in calcium cycling.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Wilson LD,Jeyaraj D,Wan X,Hoeker GS,Said TH,Gittinger M,Laurita KR,Rosenbaum DSdoi
10.1016/j.hrthm.2008.11.008subject
Has Abstractpub_date
2009-02-01 00:00:00pages
251-9issue
2eissn
1547-5271issn
1556-3871pii
S1547-5271(08)01091-6journal_volume
6pub_type
杂志文章相关文献
HEART RHYTHM文献大全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:BACKGROUND:Device replacement is the ideal time to reassess health care goals regarding continuing implantable cardioverter-defibrillator (ICD) therapy. Only few data are available on the decision making at this time. OBJECTIVES:The goals of this study were to identify factors associated with poor prognosis at the tim...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.11.024
更新日期:2020-11-27 00:00:00
abstract:BACKGROUND:The St. Jude Medical Riata family of implantable cardioverter-defibrillator (ICD) leads has demonstrated a high rate of externalized conductors and electrical failure. OBJECTIVE:Given similar design elements of Durata to Riata, the purpose of this study was to assess the rates of failure of the Riata ST Opt...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.07.050
更新日期:2013-10-01 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:Mutations in LMNA cause an arrhythmogenic cardiomyopathy (cardiolaminopathy) with high risk of ventricular tachycardia (VT). The natural history of VT among patients with cardiolaminopathy is incompletely understood. OBJECTIVE:The purpose of this study was to determine the longitudinal burden and progressio...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.05.023
更新日期:2020-10-01 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:Small-diameter implantable cardioverter-defibrillator (ICD) Sprint Fidelis and Riata leads have been recalled owing to an increased risk of lead failure, thus arousing the suspicion that lead size might be a critical issue. OBJECTIVE:To compare the incidence of failure of small-diameter (≤8 F) and standard-...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2012.10.017
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the surface electrocardiogram (ECG) morphology of common atrial tachycardias (ATs) that occur after pulmonary vein (PV) isolation. BACKGROUND:Focal ATs from reconnected PVs and macroreentrant mitral annular (MA) flutter are the most common form of ATs occurring after...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.05.008
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:The AdaptivCRT algorithm (aCRT) automatically adjusts atrioventricular delays each minute to achieve ventricular fusion through left ventricular (LV) or biventricular (BiV) pacing. aCRT is associated with superior clinical outcomes compared to standard BiV pacing, but the association of aCRT and subsequent a...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2019.05.012
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Postoperative atrial fibrillation (POAF) frequently complicates cardiac surgery and is associated with worse outcomes. The cardiac autonomic nervous system is implicated in the pathogenesis of POAF. OBJECTIVE:The purpose of this study was to determine the efficacy and safety of selective cardiac autonomic m...
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.2018.08.021
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Long QT syndrome type 1 (LQT1) is caused by mutations in KCNQ1, which encodes the α subunit of the slow delayed rectifier potassium current channel. We previously reported that a synonymous mutation, c.1032G>A, p.A344Aspl, in KCNQ1 is most commonly identified in genotyped patients with LQT1 in Japan and the ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.05.028
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:QRS morphology and QRS duration (QRSd) determine cardiac resynchronization therapy (CRT) candidate selection but criteria require refinement. OBJECTIVE:To assess CRT effect according to QRSd, treated by dichotomization vs a continuous function, and modulation by gender. METHODS:Patients selected were those...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.04.001
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Current risk schemes to predict ischemic stroke and intracranial hemorrhage (ICH) in atrial fibrillation (AF) are derived primarily using a Caucasian population. OBJECTIVE:The purpose of this study was to describe the risk of ischemic stroke and ICH in a large contemporary "real world" cohort of Chinese AF ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.04.021
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Little is known about the exact boundaries of the reentrant circuit in the slow-slow form of atrioventricular nodal reentrant tachycardia (AVNRT). OBJECTIVE:The purpose of this study was to examine the tachycardia circuit in the slow-slow form of AVNRT. METHODS:Single extrastimuli were delivered during the...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.02.010
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Patients with atrial fibrillation (AF) experience an increased risk of heart failure (HF). However, data are lacking on current trends in the risk of HF after AF. OBJECTIVE:The purpose of this study was to describe the temporal trends in HF occurrence after AF in a community cohort of patients with incident...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2017.01.031
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Left atrial (LA) low-voltage areas (LVAs) are frequently observed in patients with atrial fibrillation (AF) and may predict AF recurrence after catheter ablation. OBJECTIVE:The aim of this study was to develop and validate a clinical tool to identify LVAs that are associated with AF recurrence after pulmona...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2015.07.003
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Frequent premature ventricular complexes (PVCs) can induce or worsen left ventricular (LV) systolic dysfunction. OBJECTIVE:The purpose of this study was to identify the clinical pattern of patients having a "pure PVC-induced" cardiomyopathy at presentation. METHODS:This prospective multicenter study includ...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2017.07.025
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Findings from animal studies and small series of patients support the greater safety of cryoenergy over radiofrequency in the ablation of arrhythmic substrates near the AV node. OBJECTIVES:The purpose of this study was to systematically evaluate the electrophysiologic effects of successive cryoenergy applic...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2006.06.002
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:The population of patients likely to respond to selected pacing algorithms for maintenance of sinus rhythm is unknown. OBJECTIVES:The purpose of this study was to identify patients with specific onset patterns of paroxysmal atrial fibrillation (AF). METHODS:Dual-chamber pacemakers with advanced diagnostic ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2006.01.030
更新日期:2006-06-01 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
abstract:BACKGROUND:The reported complication rate of catheter ablation of atrial fibrillation (AF) varies. OBJECTIVE:Our goal was to assess temporal trends and the effect of both institutional and individual operators' experience on the incidence of complications. METHODS:All patients undergoing AF ablation at Johns Hopkins ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.07.025
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Antitachycardia pacing (ATP) can reduce implantable cardioverter-defibrillator shocks, but its use in children and patients with congenital heart disease (CHD) is not well described. OBJECTIVE:To review the efficacy of ATP in children and patients with CHD. METHODS:We reviewed implantable cardioverter-defi...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2012.06.042
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Patients with heart failure and sleep apnea are at increased risk for developing arrhythmias. Whether treatment of sleep apnea reduces arrhythmias is unknown. OBJECTIVE:The purpose of this study was to determine whether adaptive servo-ventilation (ASV) with optimal medical therapy (OMT) reduces atrial fibri...
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.2018.07.027
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Nontransvenous (NTV) implantable cardioverter-defibrillator (ICD) systems with pericardial and/or subcutaneous coils are used in select pediatric and congenital heart disease patients who are not candidates for transvenous ICD leads. Outcomes with these hybrid configurations are not well understood. OBJECTI...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2009.10.014
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:An ischemic etiology of heart failure (HF) has been associated with reduced left ventricular reverse remodeling after cardiac resynchronization therapy (CRT). OBJECTIVE:The purpose of this study was to assess the relationship between the etiology of HF and reverse remodeling and outcome after CRT. METHODS:...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2017.08.021
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Little is known about the tachyarrhythmias relating to respiration. Case reports presented patients with respiratory cycle-dependent atrial tachycardias (RCATs), which cyclically emerge after starting inspiration and cease during expiration. OBJECTIVE:The aim of the present study was to elucidate the preval...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.04.031
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Premature ventricular complex (PVC) ablation has been shown to improve left ventricular ejection fraction (LVEF) and New York Heart Association functional class in patients with left ventricular dysfunction. Both are considered key variables in predicting risk of sudden cardiac death. OBJECTIVE:The objectiv...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2015.09.011
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Conventional cardiac device infections are increasing in incidence, causing significant morbidity and mortality. Leadless pacemaker (LP) therapy may provide new opportunities for the management of pacemaker (PM) infections as it does not require implantation of transvenous leads and a pectoral pocket. OBJEC...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.07.006
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Left atrial appendage (LAA) occlusion with WATCHMAN has emerged as viable alternative to vitamin K antagonists in randomized controlled trials. OBJECTIVE:EWOLUTION was designed to provide data in routine practice from a prospective multicenter registry. METHODS:A total of 1025 patients scheduled for a WATC...
journal_title:Heart rhythm
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.hrthm.2017.05.038
更新日期:2017-09-01 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