| Induction of ventricular fibrillation by T wave shocks: observations from monophasic action potential recordings. | |
| | |
MedLine Citation:
|
PMID: 10525249 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Shocks given during the vulnerable period of cardiac repolarization may induce ventricular fibrillation (VF). However, the relationship of the vulnerable period and the monophasic action potential (MAP) has not yet been reported in humans. The purpose of this study was, therefore, to determine how the monophasic action potential recorded from the right ventricle correlates with inducibility of VF using T wave shocks during ventricular pacing. METHODS: Eleven patients undergoing implantable cardioverter defibrillator (ICD) implantation had a MAP catheter positioned in the right ventricle (RV). The local monophasic action potential duration at 90% repolarization (MAP90) duration was measured during pacing at 400 ms. VF induction was attempted by pacing at 400 ms for 10 cycles and then giving a 1.0 joule monophasic T wave shock at varying coupling intervals (CI) to the last paced stimulus. The maximum and minimum CI that induced VF were determined and mapped in relation to the MAP90 recording. RESULTS: The average paced MAP duration was 275 +/- 20 ms. The minimum and maximum CI to induce VF were 255 +/- 24 ms and 325 +/- 36 ms respectively. This ranged from 93% to 118% of the MAP90 duration but because of delay in conduction time to the MAP catheter, shocks that induced ventricular fibrillation occurred between 74% and 99% of local repolarization time. CONCLUSION: VF is inducible with low energy T wave shocks falling during the last 25% of the right ventricular MAP90 recording. This corresponds with VF initiation during phase III repolarization. |
| | |
Authors:
|
R K Shepard; M A Wood; D Dan; H F Clemo; D M Gilligan; K A Ellenbogen |
Related Documents
:
|
10385759 - Cardiogenic shock complicating acute myocardial infarction: predictors of death. gusto ... 14636759 - Roles of ischemia and hypoxia and the molecular pathogenesis of post-burn cardiac shock. 6326219 - Problems in the treatment of septic shock. 12053679 - Acute cardiogenic shock immediately after successful intervention for failed thrombolysis. 18362029 - Atria are more susceptible to electroporation than ventricles: implications for atrial ... 9244209 - In-hospital outcome of elderly patients with acute inferior myocardial infarction and r... 11514319 - Bradykinin elicits "second window" myocardial protection in rat heart through an no-dep... 2916759 - Can the parasternal long axis plane replace the apical four-chamber plane in diagnosing... 17011289 - Nonoperative management of omental infarction: a case report in a child. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Volume: 3 ISSN: 1383-875X ISO Abbreviation: J Interv Card Electrophysiol Publication Date: 1999 Dec |
Date Detail:
|
Created Date: 1999-12-23 Completed Date: 1999-12-23 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 9708966 Medline TA: J Interv Card Electrophysiol Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 335-40 Citation Subset: IM |
Affiliation:
|
The Department of Medicine, Division of Cardiology, Virginia Commonwealth University/Medical College of Virginia and McGuire VA Medical Center, Richmond, VA 23298-0053, USA. Keck.S@ATT.net |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Action Potentials Aged Cardiac Pacing, Artificial* Disease Susceptibility Electrocardiography Humans Middle Aged Reaction Time Ventricular Fibrillation / etiology*, physiopathology Ventricular Function, Right |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Comparison of therapy detection times between implantable cardioverter defibrillators with standard ...
Next Document: Temperature-controlled radiofrequency catheter ablation with a 10-mm tip electrode creates larger le...