| Cardiac memory in patients with Wolff-Parkinson-White syndrome: noninvasive imaging of activation and repolarization before and after catheter ablation. | |
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MedLine Citation:
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PMID: 18697818 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiac memory refers to a change in ventricular repolarization induced by and persisting for minutes to months after cessation of a period of altered ventricular activation (eg, resulting from pacing or preexcitation in patients with Wolff-Parkinson-White syndrome). ECG imaging (ECGI) is a novel imaging modality for noninvasive electroanatomic mapping of epicardial activation and repolarization. METHODS AND RESULTS: Fourteen pediatric patients with Wolff-Parkinson-White syndrome and no other congenital disease, were imaged with ECGI a day before and 45 minutes, 1 week, and 1 month after successful catheter ablation. ECGI determined that preexcitation sites were consistent with sites of successful ablation in all cases to within a 1-hour arc of each atrioventricular annulus. In the preexcited rhythm, activation-recovery interval (ARI) was the longest (349+/-6 ms) in the area of preexcitation leading to high average base-to-apex ARI dispersion of 95+/-9 ms (normal is approximately 40 ms). The ARI dispersion remained the same 45 minutes after ablation, although the activation sequence was restored to normal. ARI dispersion was still high (79+/-9 ms) 1 week later and returned to normal (45+/-6 ms) 1 month after ablation. CONCLUSIONS: The study demonstrates that ECGI can noninvasively localize ventricular insertion sites of accessory pathways to guide ablation and evaluate its outcome in pediatric patients with Wolff-Parkinson-White syndrome. Wolff-Parkinson-White is associated with high ARI dispersion in the preexcited rhythm that persists after ablation and gradually returns to normal over a period of 1 month, demonstrating the presence of cardiac memory. The 1-month time course is consistent with transcriptional reprogramming and remodeling of ion channels. |
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Authors:
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Subham Ghosh; Edward K Rhee; Jennifer N Avari; Pamela K Woodard; Yoram Rudy |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural Date: 2008-08-12 |
Journal Detail:
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Title: Circulation Volume: 118 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-26 Completed Date: 2008-09-17 Revised Date: 2011-01-10 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 907-15 Citation Subset: AIM; IM |
Affiliation:
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Cardiac Bioelectricity and Arrhythmia Center, Department of Biomedical Engineering, Washington University, St Louis, MO, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Action Potentials
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physiology Adolescent Algorithms Catheter Ablation* Child Electrocardiography / methods* Female Heart Atria Heart Conduction System / physiology Heart Ventricles Humans Male Myocardial Contraction / physiology Predictive Value of Tests Tomography, X-Ray Computed Wolff-Parkinson-White Syndrome / diagnosis*, physiopathology, surgery* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL033343-25/HL/NHLBI NIH HHS; R01-HL-49054/HL/NHLBI NIH HHS; R37-HL-33343/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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Circulation. 2009 Feb 24;119(7):e209; author reply e210
[PMID:
19237667
]
Circulation. 2008 Aug 26;118(9):899-900 [PMID: 18725500 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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