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 unsuccessful monophasic shocks of the same voltage. The heart was exposed and a 510-electrode sock with approximately 4-mm interelectrode spacing was pulled over the entire ventricular epicardium and sutured to the pericardium. Defibrillation catheters were placed in the right ventricular apex and in the superior vena cava. Paired monophasic 12 msec and biphasic 6/6 msec defibrillation shocks were given using an up-down protocol to keep shock strength between the defibrillation thresholds for the two waveforms so that the biphasic shock was successful while the monophasic shock was not. Activation fronts immediately following 60 paired shocks were recorded and analyzed by animated maps of the first derivative of the electrograms. The ventricles were divided into apical (I), middle (II), and basal (III) thirds, and early sites, i.e., the sites from which activation fronts first appeared on the epicardium following the shock, were grouped according to their location. Postshock intervals, i.e., the time from the shock until earliest epicardial activation occurred, were also determined. No ectopic activation fronts followed the shock in 20 biphasic episodes. In the other 40 paired episodes, the number of early sites was smaller after biphasic shocks than after monophasic shocks [monophasic: 198 (total), 3.3 +/- 0.9 (mean +/- SD) per shock episode; biphasic: 67, 1.1 +/- 1.0, P < 0.05]. For biphasic but not monophasic shocks, early sites were less likely to arise from the middle (II) and basal (III) thirds than from the apical third (I) [monophasic: I: 84 (42%), II: 68 (34%), III: 46 (23%); biphasic: I: 49 (73%), II: 10 (15%), III: 8 (12%), P < 0.05]. Postshock intervals were significantly shorter for monophasic shocks (54 +/- 14 msec) than for biphasic shocks (75 +/- 23 msec, P < 0.05). CONCLUSION:The decreased number of activation fronts and the longer delay following the shock for the earliest epicardial appearance of those activation fronts that do occur may be responsible for the increased defibrillation efficacy for biphasic shocks.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Usui M,Callihan RL,Walker RG,Walcott GP,Rollins DL,Wolf PD,Smith WM,Ideker REdoi
10.1111/j.1540-8167.1996.tb00533.xsubject
Has Abstractpub_date
1996-04-01 00:00:00pages
322-34issue
4eissn
1045-3873issn
1540-8167journal_volume
7pub_type
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.2008.01295.x
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journal_title:Journal of cardiovascular electrophysiology
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更新日期:2015-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.2009.01714.x
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abstract:BACKGROUND:Low conduction velocity (CV) in the area showing low electrogram amplitude (EA) is characteristic of reentry circuit of atypical atrial flutter (AFL). The quantitative relationship between CV and EA remains unclear. We characterized AFL reentry circuit in the right atrium (RA), focusing on the relationship b...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12329
更新日期:2014-04-01 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:BACKGROUND:Unfortunately, some patients with long QT syndrome (LQTS) experience breakthrough cardiac events (BCEs) despite maximal therapy. Small studies have shown that refractory LQTS cases may benefit from intentional permanent atrial pacing (IPAP). As such, we sought to determine the genotype-specific utilization a...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14920
更新日期:2021-01-29 00:00:00
abstract:UNLABELLED:VT Ablation in Apical Hypertrophic Cardiomyopathy. INTRODUCTION:Monomorphic ventricular tachycardia (VT) is uncommon in apical hypertrophic cardiomyopathy (HCM). The purpose of this study was to define the substrate and role of catheter ablation for VT in apical HCM. METHODS:Four patients with apical HCM ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.01875.x
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Primary prevention ICD trials have excluded patients with CKD. Comorbidities and lower life expectancy in patients with CKD make the benefit of primary prevention ICD implantation uncertain. METHODS:A decision analysis model was devised to evaluate the risks and benefits of implantable cardioverter-defibr...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01258.x
更新日期:2008-12-01 00:00:00
abstract:INTRODUCTION:The mechanisms that maintain ventricular fibrillation (VF) are not completely understood. It has been proposed that increased ventricular wall thickness destabilizes VF wavefronts and therefore is an important determinant of VF activation patterns. We hypothesized that if this is the case, then VF patterns...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2000.01364.x
更新日期:2000-12-01 00:00:00
abstract::We report the case of a 28-year-old man with no structural heart disease, who exhibited clearly augmented ST segment elevation in the right precordial leads, followed by induction of spontaneous right ventricular outflow tract tachycardia with intravenous administration of Class IA antiarrhythmic drugs. The electrophy...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00838.x
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) increases morbidity and mortality in patients with previous myocardial infarction and left ventricular systolic dysfunction. The purpose of this study was to identify patients with a high risk for new-onset AF in this population using invasive and noninvasive electrophysiological tes...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.01795.x
更新日期:2010-09-01 00:00:00
abstract:INTRODUCTION:Previous studies have underscored the importance of the interpulmonary isthmus in the initiation and maintenance of atrial fibrillation (AF). The efficacy of additional radiofrequency energy delivery in the interpulmonary isthmus following pulmonary vein antral isolation (PVAI) was investigated. METHODS A...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/jce.12399
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Catheter ablation of atrial fibrillation (AF) currently relies on eliminating triggers, and no reliable method exists to map the arrhythmia itself to identify ablation targets. The aim of this multicenter study was to define the use of Focal Impulse and Rotor Modulation (FIRM) for identifying ablation targ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/jce.12000
更新日期:2012-12-01 00:00:00
abstract:INTRODUCTION:Oral anticoagulation therapy reduces significantly the risk of thromboembolism in patients with atrial fibrillation. However, effective oral anticoagulation therapy is not feasible in all patients. The interventional occlusion of the left atrial appendage may reduce the risk of thromboembolism in the latte...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.14.s9.11.x
更新日期:2003-09-01 00:00:00
abstract::About one fifth of all deaths occur suddenly and unexpectedly, often as the first manifestation of heart disease. Several tests have been developed during the past 2 decades for risk stratification of such an event, but only a minority of victims can be identified as being at high risk before sudden death occurs. Impr...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.14.ss9.1.x
更新日期:2003-09-01 00:00:00
abstract:INTRODUCTION:Bundle branch reentry ventricular tachycardia (VT) is usually amenable to treatment with radiofrequency ablation. Different QRS morphologies during VT are possible when anterograde ventricular activation is over the left bundle branch. Manifestations of this reentrant tachycardia with more than one QRS mor...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb01832.x
更新日期:1997-06-01 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:INTRODUCTION:Atrial fibrillation and atrial flutter often coexist. The long-term occurrence of atrial fibrillation in patients presenting with atrial flutter alone is unknown. We report the long-term follow-up in patients who underwent cavotricuspid isthmus ablation for treatment of lone atrial flutter. METHODS AND RE...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2007.00885.x
更新日期:2007-08-01 00:00:00
abstract:INTRODUCTION:Quinidine has been evaluated in patients with a short QT-1 syndrome caused by an IKr gain-of-function mutation of HERG. Recently, in vitro data with disopyramide showed an even stronger effect on the N588K mutant current. The aim of the present study was to test the in vivo effects of disopyramide in patie...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.00925.x
更新日期:2007-11-01 00:00:00
abstract::This commentary discusses two techniques commonly used to analyze clinical trials: subgroup analysis and meta-analysis. Subgroup analysis is used to evaluate the consistency of a treatment across multiple groups, usually within a clinical trial. Subgroup analysis often is used to generate or test an hypothesis about r...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.14.s9.1.x
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:This study aimed to assess manpower and resource consumption of the HomeGuide workflow model for remote monitoring (Biotronik Home Monitoring [HM], Biotronik SE & Co. KG, Berlin, Germany) of cardiac implantable electronic devices in daily clinical practice. METHODS:The model established a cooperative intera...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.12482
更新日期:2014-11-01 00:00:00
abstract:INTRODUCTION:Stimulants are the mainstay therapy for attention deficit/hyperactivity disorder (ADHD) and are associated with adrenergic side effects. There are limited data on the clinical course of patients treated for ADHD who have long-QT syndrome (LQTS), for which β-blockade is the goal of therapy. METHODS:LQTS pa...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/jce.12739
更新日期:2015-10-01 00:00:00
abstract::The ECG appearance in Brugada syndrome is caused by failure of the dome of the action potential to develop. Increased activity of the I(to) current in epicardial cells generates a transmural gradient with repolarization dispersion between the epicardium and the endocardium in the right ventricular wall, thus favoring ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.00290.x
更新日期:2006-02-01 00:00:00
abstract:INTRODUCTION:Treatment refractory ventricular arrhythmias (VAs) are often driven and exacerbated by heightened sympathetic tone. We aim to conduct a systematic review and meta-analysis of published studies of a temporary percutaneous stellate ganglion block (SGB) on VA burden and defibrillation episodes in patients wit...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jce.13324
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:The atrial outcome after extensive ablation is unknown. We sought to quantify atrial structure and function years after successful ablation for persistent atrial fibrillation (PsAF). METHODS AND RESULTS:We studied after 80 ± 15 months 26 patients (54 ± 8 years, 1 woman) with PsAF successfully treated by a...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12449
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Atrial fibrillation (AF) ablation is increasingly common, but is associated with potential major complications. Technology, experience, and protocols have evolved significantly in recent times, and may have impacted procedural safety. We sought to compare AF ablation safety profiles, including complication...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13484
更新日期:2018-06-01 00:00:00
abstract:INTRODUCTION:Irregularity measures have been suggested as risk indicators in patients with atrial fibrillation (AF); however, it is not known to what extent they are affected by commonly used rate-control drugs. We aimed at evaluating the effect of metoprolol, carvedilol, diltiazem, and verapamil on the variability and...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,随机对照试验
doi:10.1111/jce.12580
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Two hypotheses have been proposed to explain the mechanisms of vulnerability and related failure of defibrillation therapy: the cross-field-induced critical point hypothesis and the virtual electrode-induced phase singularity hypothesis. These two hypotheses predict the opposite effect of preshock repolari...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00172.x
更新日期:2000-09-01 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:Immediate reinitiation of atrial tachyarrhythmia (IRAT) is an important cause of failure to maintain sinus rhythm. IRAT prevention by overdrive pacing has not been evaluated in a prospective randomized trial. METHODS AND RESULTS:Patients with a DDDRP pacemaker offering temporary atrial overdrive pacing af...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-09-01 00:00:00