Contribution of myocardium responsible for ventricular tachycardia to abnormalities detected by analysis of signal-averaged ECGs.


BACKGROUND:Current methods of signal-averaged ECG analysis interrogate the terminal 40 msec of the QRS complex and/or the ST segment and have a low positive-predictive accuracy for detecting vulnerability to sustained ventricular tachycardia (VT). The extent to which abnormalities detected during these ECG intervals are generated by myocardial tissue responsible for VT has not been well defined. The purpose of this study was to determine when, during sinus rhythm, myocardium responsible for VT is activated. METHODS AND RESULTS:Three-dimensional ventricular activation maps were analyzed during sinus rhythm and during 10 VTs in eight patients with healed myocardial infarctions undergoing arrhythmia surgery for sustained monomorphic VT. The mechanism of VT was focal in five instances and macroreentrant in five. During sinus beats, myocardium responsible for all focal VTs activated 43 +/- 38 msec before the onset of the terminal 40-msec interval of the QRS complex. During sinus rhythm, activation of the myocardium critical to macroreentrant VT began 72 +/- 13 msec before the onset of the terminal QRS interval and in only three instances extended 2-25 msec into the terminal 40 msec of the QRS complex. Electrograms recorded during the ST segment represented late activation of epicardial sites overlying zones of infarction that were temporally and spatially remote from tissue critical to VT. CONCLUSIONS:Current methods of signal-averaged ECG analysis limiting interrogation to the terminal QRS/ST segment exclude detection of > 95% of the signals generated by myocardium responsible for sustained VT. These results establish a pathophysiological basis for expanding signal-averaged ECG analysis to include more of the cardiac cycle.






Hood MA,Pogwizd SM,Peirick J,Cain ME




Has Abstract


1992-12-01 00:00:00












  • Direct evidence for tumor necrosis factor-alpha signaling in arteriogenesis.

    abstract:BACKGROUND:Arteriogenesis serves as an efficient mechanism for flow restoration after arterial occlusion. This process is associated with inflammatory mediators such as tumor necrosis factor-alpha (TNF-alpha), although their role in arteriogenesis remains unclear. We hypothesized that arteriogenesis is reduced in mice ...


    pub_type: 杂志文章


    authors: Hoefer IE,van Royen N,Rectenwald JE,Bray EJ,Abouhamze Z,Moldawer LL,Voskuil M,Piek JJ,Buschmann IR,Ozaki CK

    更新日期:2002-04-09 00:00:00

  • Stimulated activation of platelet-derived growth factor receptor in vivo in balloon-injured arteries: a link between angiotensin II and intimal thickening.

    abstract:BACKGROUND:Growth factors such as platelet-derived growth factor (PDGF) have been postulated to be important mediators of neointimal formation in balloon-injured artery. Binding of growth factors to their receptors activates intrinsic receptor tyrosine kinase, resulting in tyrosine phosphorylation of receptors themselv...


    pub_type: 杂志文章


    authors: Abe J,Deguchi J,Matsumoto T,Takuwa N,Noda M,Ohno M,Makuuchi M,Kurokawa K,Takuwa Y

    更新日期:1997-09-16 00:00:00

  • Effect of inhaled iloprost plus oral sildenafil in patients with primary pulmonary hypertension.

    abstract:BACKGROUND:The application of iloprost, a stable prostacyclin analogue, by inhalation has been shown to improve hemodynamic variables in patients with primary pulmonary hypertension. However, repetitive inhalations are required due to its short-term effects. One potential approach to prolong and increase the vasorelaxa...


    pub_type: 临床试验,杂志文章


    authors: Wilkens H,Guth A,König J,Forestier N,Cremers B,Hennen B,Böhm M,Sybrecht GW

    更新日期:2001-09-11 00:00:00

  • Exercise conditioning in older coronary patients. Submaximal lactate response and endurance capacity.

    abstract:BACKGROUND:Older coronary patients are at high risk of cardiac disability. Exercise conditioning programs have been demonstrated to improve functional capacity, particularly in younger coronary patients. In this study, the effects of aerobic conditioning on submaximal and maximal indicators of exercise performance were...


    pub_type: 杂志文章


    authors: Ades PA,Waldmann ML,Poehlman ET,Gray P,Horton ED,Horton ES,LeWinter MM

    更新日期:1993-08-01 00:00:00

  • Prediction of lifetime risk for cardiovascular disease by risk factor burden at 50 years of age.

    abstract:BACKGROUND:Lifetime risk for atherosclerotic cardiovascular disease (CVD) has not previously been estimated, and the effect of risk factor burden on lifetime risk is unknown. METHODS AND RESULTS:We included all Framingham Heart Study participants who were free of CVD (myocardial infarction, coronary insufficiency, ang...


    pub_type: 杂志文章


    authors: Lloyd-Jones DM,Leip EP,Larson MG,D'Agostino RB,Beiser A,Wilson PW,Wolf PA,Levy D

    更新日期:2006-02-14 00:00:00

  • Clinical pharmacokinetics and efficacy of amiodarone for refractory tachyarrhythmias.

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    pub_type: 杂志文章


    authors: Haffajee CI,Love JC,Canada AT,Lesko LJ,Asdourian G,Alpert JS

    更新日期:1983-06-01 00:00:00

  • Long-term safety and efficacy of percutaneous coronary intervention with stenting and coronary artery bypass surgery for multivessel coronary artery disease: a meta-analysis with 5-year patient-level data from the ARTS, ERACI-II, MASS-II, and SoS trials.

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    pub_type: 杂志文章,meta分析


    authors: Daemen J,Boersma E,Flather M,Booth J,Stables R,Rodriguez A,Rodriguez-Granillo G,Hueb WA,Lemos PA,Serruys PW

    更新日期:2008-09-09 00:00:00

  • Overexpression of thioredoxin-1 in transgenic mice attenuates adriamycin-induced cardiotoxicity.

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    pub_type: 杂志文章


    authors: Shioji K,Kishimoto C,Nakamura H,Masutani H,Yuan Z,Oka S,Yodoi J

    更新日期:2002-09-10 00:00:00

  • Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations.

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    pub_type: 共识发展会议,杂志文章


    authors: Whelton PK,Appel LJ,Sacco RL,Anderson CA,Antman EM,Campbell N,Dunbar SB,Frohlich ED,Hall JE,Jessup M,Labarthe DR,MacGregor GA,Sacks FM,Stamler J,Vafiadis DK,Van Horn LV

    更新日期:2012-12-11 00:00:00

  • Inflammation in atherosclerosis: visualizing matrix metalloproteinase action in macrophages in vivo.

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    pub_type: 杂志文章


    authors: Deguchi JO,Aikawa M,Tung CH,Aikawa E,Kim DE,Ntziachristos V,Weissleder R,Libby P

    更新日期:2006-07-04 00:00:00

  • Vascular injury, repair, and restenosis after percutaneous transluminal angioplasty in the atherosclerotic rabbit.

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    pub_type: 杂志文章


    authors: Wilensky RL,March KL,Gradus-Pizlo I,Sandusky G,Fineberg N,Hathaway DR

    更新日期:1995-11-15 00:00:00

  • Does coronary artery bypass surgery restore normal maximal coronary flow reserve? The effect of diffuse atherosclerosis and focal obstructive lesions.

    abstract::Aortocoronary vein bypass surgery might not restore normal maximal coronary flow reserve to bypassed coronary vessels because residual diffuse coronary atherosclerosis might limit maximal hyperemia. To investigate the effect of diffuse atherosclerosis and a focal stenosis at the graft-coronary anastomosis, we measured...


    pub_type: 杂志文章


    authors: Wilson RF,White CW

    更新日期:1987-09-01 00:00:00

  • Use of a novel endoscopic catheter for direct visualization and ablation in an ovine model of chronic myocardial infarction.

    abstract:BACKGROUND:Defining the arrhythmogenic substrate is essential for successful ablation of scar-related ventricular tachycardia. The visual characteristics of endocardial ischemic scar have not been described in vivo. The goal of this study was (1) to quantify the visual characteristics of normal tissue, scar border zone...


    pub_type: 杂志文章


    authors: Betensky BP,Jauregui M,Campos B,Michele J,Marchlinski FE,Oley L,Wylie B,Robinson D,Gerstenfeld EP

    更新日期:2012-10-23 00:00:00

  • Unexpected interaction between beta-adrenergic blockade and heart rate variability before and after myocardial infarction. A longitudinal study in dogs at high and low risk for sudden death.

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    pub_type: 杂志文章


    authors: Adamson PB,Huang MH,Vanoli E,Foreman RD,Schwartz PJ,Hull SS Jr

    更新日期:1994-08-01 00:00:00

  • Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study.

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    pub_type: 杂志文章


    authors: Brunner EJ,Hemingway H,Walker BR,Page M,Clarke P,Juneja M,Shipley MJ,Kumari M,Andrew R,Seckl JR,Papadopoulos A,Checkley S,Rumley A,Lowe GD,Stansfeld SA,Marmot MG

    更新日期:2002-11-19 00:00:00

  • Mechanistic target of rapamycin complex 2 protects the heart from ischemic damage.

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    pub_type: 杂志文章


    authors: Völkers M,Konstandin MH,Doroudgar S,Toko H,Quijada P,Din S,Joyo A,Ornelas L,Samse K,Thuerauf DJ,Gude N,Glembotski CC,Sussman MA

    更新日期:2013-11-05 00:00:00

  • The abnormal exercise electrocardiogram in apparently healthy men: a predictor of angina pectoris as an initial coronary event during long-term follow-up.

    abstract::A group of 916 apparently healthy men between the ages of 27 and 55 years (mean 37) were followed up with serial medical and exercise test evaluations for a period of 8 to 15 years (mean 12.7) to determine (1) the prevalence and specific types of new coronary events observed in subjects with and without abnormal ST se...


    pub_type: 杂志文章


    authors: McHenry PL,O'Donnell J,Morris SN,Jordan JJ

    更新日期:1984-10-01 00:00:00

  • Long-term tocainide therapy for ventricular arrhythmias.

    abstract::Long-term tocainide therapy has been evaluated in 17 patients with ventricular arrhythmias. Ventricular tachycardia and/or fibrillation was recurrent and sustained in nine patients, and symptomatic but unsustained in three others. Five patients had frequent but only mildly symptomatic ventricular irritability. In all ...


    pub_type: 杂志文章


    authors: Winkle RA,Meffin PJ,Harrison DC

    更新日期:1978-05-01 00:00:00

  • Quantitative assessment of right and left ventricular growth in the human fetal heart: a pathoanatomic study.

    abstract::We quantitated the growth patterns of the normal fetal heart and the right and left ventricles from postmortem hearts obtained from 55 spontaneously aborted human fetuses from the completion of cardiogenesis to term. Fetal gestational age was assessed by menstrual history of the mother, crown-rump length, head circumf...


    pub_type: 杂志文章


    authors: St John Sutton MG,Raichlen JS,Reichek N,Huff DS

    更新日期:1984-12-01 00:00:00

  • Matrix-dependent mechanism of neutrophil-mediated release and activation of matrix metalloproteinase 9 in myocardial ischemia/reperfusion.

    abstract:BACKGROUND:A key component of reperfusion of myocardial infarction is an immediate inflammatory response, which enhances tissue repair. Matrix turnover is crucial to tissue repair, and matrix metalloproteinases (MMPs) are key enzymes involved in matrix degradation. The hypothesis tested is that one inflammation-based e...


    pub_type: 杂志文章


    authors: Lindsey M,Wedin K,Brown MD,Keller C,Evans AJ,Smolen J,Burns AR,Rossen RD,Michael L,Entman M

    更新日期:2001-05-01 00:00:00

  • Targeted molecular probes for imaging atherosclerotic lesions with magnetic resonance using antibodies that recognize oxidation-specific epitopes.

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    pub_type: 杂志文章


    authors: Briley-Saebo KC,Shaw PX,Mulder WJ,Choi SH,Vucic E,Aguinaldo JG,Witztum JL,Fuster V,Tsimikas S,Fayad ZA

    更新日期:2008-06-24 00:00:00

  • Sex differences in perioperative and long-term cardiac event-free survival in vascular surgery patients. An analysis of clinical and scintigraphic variables.

    abstract:BACKGROUND:Little information is available regarding the occurrence of perioperative and late cardiac events in women with vascular disease. The current study was performed to examine whether sex-specific differences exist in these outcomes in a large population of vascular surgery patients and to determine the value o...


    pub_type: 杂志文章


    authors: Hendel RC,Chen MH,L'Italien GJ,Newell JB,Paul SD,Eagle KA,Leppo JA

    更新日期:1995-02-15 00:00:00

  • Heat shock treatment enhances graft cell survival in skeletal myoblast transplantation to the heart.

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    pub_type: 杂志文章


    authors: Suzuki K,Smolenski RT,Jayakumar J,Murtuza B,Brand NJ,Yacoub MH

    更新日期:2000-11-07 00:00:00

  • Randomized comparison of percutaneous transluminal coronary angioplasty and medical therapy in stable survivors of acute myocardial infarction with single vessel disease: a study of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte.

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    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Zeymer U,Uebis R,Vogt A,Glunz HG,Vöhringer HF,Harmjanz D,Neuhaus KL,ALKK-Study Group.

    更新日期:2003-09-16 00:00:00

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    pub_type: 杂志文章


    authors: Mattera R,Stone GP,Bahhur N,Kuryshev YA

    更新日期:2001-05-15 00:00:00

  • Increased tolerance of the chronically hypoxic immature heart to ischemia. Contribution of the KATP channel.

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    pub_type: 杂志文章


    authors: Baker JE,Curry BD,Olinger GN,Gross GJ

    更新日期:1997-03-04 00:00:00

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    pub_type: 杂志文章


    authors: Fuse K,Kodama M,Okura Y,Ito M,Hirono S,Kato K,Hanawa H,Aizawa Y

    更新日期:2000-12-05 00:00:00

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    pub_type: 杂志文章


    authors: Banai S,Wolf Y,Golomb G,Pearle A,Waltenberger J,Fishbein I,Schneider A,Gazit A,Perez L,Huber R,Lazarovichi G,Rabinovich L,Levitzki A,Gertz SD

    更新日期:1998-05-19 00:00:00

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    pub_type: 杂志文章


    authors: Littler WA,Honour AJ,Pugsley DJ,Sleight P

    更新日期:1975-06-01 00:00:00

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    pub_type: 杂志文章


    authors: Treat-Jacobson D,McDermott MM,Beckman JA,Burt MA,Creager MA,Ehrman JK,Gardner AW,Mays RJ,Regensteiner JG,Salisbury DL,Schorr EN,Walsh ME,American Heart Association Council on Peripheral Vascular Disease; Council on Cardiovascular

    更新日期:2019-09-24 00:00:00