Document Detail

Association among intracardiac T-wave alternans, ischemia, and spontaneous ventricular arrhythmias after coronary artery occlusion in a canine model.
MedLine Citation:
PMID:  22005265     Owner:  NLM     Status:  MEDLINE    
T-wave alternans (TWA) has been investigated as a marker for susceptibility to lethal ventricular arrhythmia. In this article, we studied intracardiac TWA and ischemia as predictors of spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) in a canine model of coronary artery occlusion (CAO). Anesthetized, open-chest dogs were studied. Electrograms from intracardiac bipolar electrodes (IBEs) were assessed for TWA and spontaneous VT or VF. TWA was defined on IBE as T wave voltage change on every other complex. In each heart, we examined 62 electrograms measured in the risk zone and surrounding normal sites, filtered from 3 to 1300 Hz. Ischemia was measured as percent of all IBE recorded that had QRS voltage drop >45%. Mapping localized the three-dimensional origin of spontaneous VT or VF. The data from dogs with VF (n = 5), VT (n = 8), or controls (no VT or VF, n = 8) were analyzed before left CAO, at the 20th min after CAO and times immediately preceding VT and VF. We found a correlation between intracardiac TWA and ischemia. More importantly, increases in intracardiac TWA peaked immediately preceding spontaneous VF and VT and were significantly higher compared to controls at comparable times. At VT/VF origins and adjacent sites, the mean TWA magnitude and discordance of TWA distinguished between VT/VF and controls at comparable times but not between VT and VF or between reentry and focal mechanisms. TWA was more common than ischemia at VT/VF origins. In summary, changes in intracardiac TWA and ischemia correlate with impending spontaneous VT/VF in a clinically applicable canine model of CAO.
Michael A Kwofie; Ashok K Chaudhary; James B Martins
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2011-08-03
Journal Detail:
Title:  Translational research : the journal of laboratory and clinical medicine     Volume:  158     ISSN:  1878-1810     ISO Abbreviation:  Transl Res     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-18     Completed Date:  2011-12-07     Revised Date:  2012-07-18    
Medline Journal Info:
Nlm Unique ID:  101280339     Medline TA:  Transl Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  265-72     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
Division of Cardiovascular Diseases, Department of Internal Medicine, University of Iowa College of Medicine and Veterans Administration Medical Center, Iowa City, USA.
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MeSH Terms
Coronary Occlusion / complications*
Disease Models, Animal
Myocardial Ischemia / physiopathology*
Tachycardia, Ventricular / etiology*
Ventricular Fibrillation / etiology*
Comment In:
Transl Res. 2012 May;159(5):415   [PMID:  22500515 ]
Transl Res. 2012 Jun;159(6):507   [PMID:  22633102 ]

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