Document Detail


Electrocardiographic ventricular repolarization during cardiovascular autonomic function testing in patients with arrhythmogenic right ventricular cardiomyopathy.
MedLine Citation:
PMID:  18615356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) experience exercise-related malignant arrhythmias possibly based on delayed repolarization in the diseased right ventricle (RV). Autonomic interventions might unveil repolarization abnormalities in RV. DESIGN: We recorded 25-lead electrocardiograms from nine symptomatic ARVC patients and nine controls during rest, Valsalva maneuver, mental stress, handgrip and supine exercise. Interventricular repolarization gradient was defined as difference of QT intervals between left ventricular (LV) and RV type leads. T-wave peak to T-wave end interval (TPE) was defined as the electrocardiographic (ECG) equivalent of transmural dispersion of repolarization. RESULTS: ARVC patients showed longer QT and TPE intervals in RV than in LV whereas control subjects showed the opposite. Valsalva strain reversed the interventricular repolarization gradient from -5+/-13 to 4+/-20 ms (p<0.02) and induced fluctuation of TPE in ARVC patients. CONCLUSIONS: ARVC patients show ECG interventricular repolarization gradient from RV to LV and increased ECG transmural dispersion of repolarization in RV. Valsalva strain induces fluctuation of interventricular repolarization gradient and of transmural dispersion of repolarization in RV possibly modifying the substrate for arrhythmias.
Authors:
Petri Haapalahti; Matti Viitasalo; Maija Kaartinen; Heikki Väänänen; Lasse Oikarinen; Tiina Heliö; Lauri Toivonen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  42     ISSN:  1651-2006     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-03     Completed Date:  2009-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  375-82     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Helsinki University Hospital, Helsinki, Finland. petri.haapalahti@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Action Potentials
Adult
Arrhythmogenic Right Ventricular Dysplasia / diagnosis*,  physiopathology
Autonomic Nervous System / physiopathology*
Body Surface Potential Mapping*
Case-Control Studies
Exercise Test
Female
Hand Strength
Heart Rate
Heart Ventricles / innervation*
Humans
Male
Middle Aged
Stress, Psychological / physiopathology
Time Factors
Valsalva Maneuver
Comments/Corrections
Comment In:
Scand Cardiovasc J. 2008 Dec;42(6):363-5   [PMID:  18924017 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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