| A Novel Pacing Method to Suppress Repolarization Alternans in Vivo: Implications for Arrhythmia Prevention. | |
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MedLine Citation:
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PMID: 23274372 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Repolarization alternans (RA), a pattern of ventricular repolarization which repeats on an every other beat basis, has been closely linked with the substrate associated with ventricular tachycardia/ventricular fibrillation (VT/VF). OBJECTIVE: To evaluate a novel method to suppress RA. METHODS: We have developed a novel method to dynamically (upon R-wave detection) trigger pacing pulses during the absolute refractory period. We have tested the ability of this method to control RA in a structurally normal swine heart in vivo. RESULTS: RA induced by triggered pacing can be measured from both intra-cardiac and body surface leads and the amplitude of R-wave triggered-pacing induced alternans can be locally modulated by varying the amplitude and width of the pacing pulse. We have estimated that to induce a one μV change in alternans voltage on the body surface, coronary sinus (CS) and left ventricle (LV) leads requires a triggered pacing pulse delivered in the right ventricle (RV) of 0.04 ± 0.02, 0.05 ± 0.025 and 0.06 ± 0.033 μC, respectively. Similarly, to induce a one unit change in K(score) (ratio of alternans peak to noise) requires a pacing stimulus of 0.93 ± 0.73, 0.32 ± 0.29 and 0.33 ± 0.37 μC, respectively. We have been able to demonstrate that RA can be suppressed by R-wave triggered pacing from a site that is within or across ventricles. Lastly, we have demonstrated that the proposed method can be used to suppress spontaneously occurring alternans in the diseased heart. CONCLUSIONS: We have developed a novel method to suppress RA in-vivo. |
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Authors:
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Antonis A Armoundas; Eric H Weiss; Omid Sayadi; Shawna Laferriere; Naveen Sajja; Theofanie Mela; Jagmeet P Singh; Conor D Barrett; E Kevin Heist; Faisal M Merchant |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-27 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: - ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012. Published by Elsevier Inc. |
Affiliation:
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the Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA; the Massachusetts General Hospital, Division of Cardiology, Harvard Medical School, Boston, MA. Electronic address: aarmoundas@partners.org. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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