Document Detail


Human model simulating right ventricular outflow tract tachycardia by high-frequency stimulation in the left pulmonary artery: autonomics and idiopathic ventricular arrhythmias.
MedLine Citation:
PMID:  19298565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Frequent monomorphic premature ventricular contractions (PVC) and/or ventricular tachycardia (VT) in patients with structurally normal heart usually arise from the right ventricular outflow tract (RVOT). An animal model simulating RVOT tachycardia by high-frequency stimulation (HFS) of the sympathetic input to the proximal pulmonary artery (PA) has been previously described. The aim of this study was to similarly induce RVOT tachycardia in humans. METHODS: In 9 patients with no history of ventricular arrhythmias, a circumferential catheter was placed in the left, main, and proximal PA to contact the endovascular circumference of the PA. A 50-ms train of HFS (200 Hz/0.3 ms pulse duration), coupled to atrial pacing, was applied at each bipolar pair of the circumferential catheter. The coupling interval was adjusted so that the 50-ms train occurred during the ventricular refractory period. RESULTS: In 6 out of 9 patients, HFS in the left PA during dobutamine infusion induced monomorphic PVCs and/or VT with left bundle branch block (LBBB) morphology and inferior axis at an average stimulation level of 12.5 +/- 2.7 V. HFS in the main PA and in the proximal PA did not induce any ventricular arrhythmias with the highest energy of 15 V in baseline state and during dobutamine infusion. HFS in the left PA was associated with hiccough in all patients. CONCLUSION: Stimulation of the sympathetic input to the left PA during dobutamine infusion induces PVCs and/or VT exhibiting LBBB-morphology and inferior axis, closely simulating clinical RVOT tachycardia in humans.
Authors:
Can Hasdemir; Alpay Alp; Mehmet Aydin; Levent H Can
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Publication Detail:
Type:  Journal Article     Date:  2009-02-27
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  20     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-14     Completed Date:  2009-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  759-63     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Ege University School of Medicine, Bornova, Izmir, Turkey. canrfca@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / administration & dosage
Adult
Bundle-Branch Block / etiology*,  physiopathology
Cardiac Pacing, Artificial
Dobutamine / administration & dosage
Electric Stimulation* / instrumentation
Electrocardiography
Electrophysiologic Techniques, Cardiac* / instrumentation
Equipment Design
Female
Heart / innervation*
Humans
Infusions, Intravenous
Male
Middle Aged
Pulmonary Artery / innervation*
Refractory Period, Electrophysiological
Reproducibility of Results
Sympathetic Nervous System / physiopathology*
Tachycardia, Ventricular / etiology*,  physiopathology
Time Factors
Young Adult
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 34368-04-2/Dobutamine

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


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