| Repolarization changes underlying long-term cardiac memory due to right ventricular pacing: noninvasive mapping with electrocardiographic imaging. | |
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MedLine Citation:
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PMID: 22772896 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiac memory refers to the observation that altered cardiac electrical activation results in repolarization changes that persist after the restoration of a normal activation pattern. Animal studies, however, have yielded disparate conclusions, both regarding the spatial pattern of repolarization changes in cardiac memory and the underlying mechanisms. The present study was undertaken to produce 3-dimensional images of the repolarization changes underlying long-term cardiac memory in humans. METHODS AND RESULTS: Nine adult subjects with structurally normal hearts and dual-chamber pacemakers were enrolled in the study. Noninvasive electrocardiographic imaging was used before and after 1 month of ventricular pacing to reconstruct epicardial activation and repolarization patterns. Eight subjects exhibited cardiac memory in response to ventricular pacing. In all subjects, ventricular pacing resulted in a prolongation of the activation recovery interval (a surrogate for action potential duration) in the region close to the site of pacemaker-induced activation from 228.4±7.6 ms during sinus rhythm to 328.3±6.2 ms during cardiac memory. As a consequence, increases are observed in both apical-basal and right-left ventricular gradients of repolarization, resulting in a significant increase in the dispersion of repolarization. CONCLUSIONS: These results demonstrate that electrical remodeling in response to ventricular pacing in human subjects results in action potential prolongation near the site of abnormal activation and a marked dispersion of repolarization. This dispersion of repolarization is potentially arrhythmogenic and, intriguingly, was less evident during continuous right ventricular pacing, suggesting the novel possibility that continuous right ventricular pacing at least partially suppresses pacemaker-induced cardiac memory. |
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Authors:
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Scott B Marrus; Christopher M Andrews; Daniel H Cooper; Mitchell N Faddis; Yoram Rudy |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2012-07-06 |
Journal Detail:
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Title: Circulation. Arrhythmia and electrophysiology Volume: 5 ISSN: 1941-3084 ISO Abbreviation: Circ Arrhythm Electrophysiol Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-08-16 Completed Date: 2012-10-26 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 101474365 Medline TA: Circ Arrhythm Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 773-81 Citation Subset: IM |
Affiliation:
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Cardiovascular Division, Washington University School of Medicine, St. Louis, MO, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Action Potentials Adult Aged Aged, 80 and over Analysis of Variance Arrhythmias, Cardiac / diagnosis, physiopathology, therapy* Cardiac Pacing, Artificial* Electrocardiography Electrophysiologic Techniques, Cardiac Equipment Design Female Heart Conduction System / physiopathology* Heart Ventricles / physiopathology* Humans Male Middle Aged Missouri Pacemaker, Artificial* Predictive Value of Tests Recovery of Function Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL033343/HL/NHLBI NIH HHS; R01 HL049054/HL/NHLBI NIH HHS; R01-HL-033343-26/HL/NHLBI NIH HHS; R01-HL-049054-18/HL/NHLBI NIH HHS; T32 HL-007275/HL/NHLBI NIH HHS; T32 HL007275/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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