| Slow conduction in the infarcted human heart. 'Zigzag' course of activation. | |
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MedLine Citation:
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PMID: 8353918 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Ventricular tachycardias occurring in the chronic phase of myocardial infarction are caused by reentry. Areas of slow conduction, facilitating reentry, are often found in the infarcted zone. The purpose of this study was to elucidate the mechanism of slow conduction in the chronic infarcted human heart. METHODS AND RESULTS: Spread of activation was studied in infarcted papillary muscles from hearts of patients who underwent heart transplantation because of infarction. Recordings were carried out on 10 papillary muscles that were superfused in a tissue bath. High-resolution mapping was performed in areas revealing slow conduction. Activation delay between sites perpendicular to the fiber direction and 1.4 mm apart could be as long as 45 milliseconds. Analysis of activation times revealed that activation spread in tracts parallel to the fiber direction. Conduction velocity in the tracts was between 0.6 and 1 m/s. Although tracts were separated from each other over distances up to 8 mm, they often connected with each other at one or more sites, forming a complex network of connected tracts. In this network, wave fronts could travel perpendicular to the fiber direction. Separation of tracts was due to collagenous septa. At sites where tracts were interconnected, the collagenous barriers were interrupted. CONCLUSIONS: Slow conduction perpendicular to the fiber direction in infarcted myocardial tissue is caused by a "zigzag" course of activation at high speed. Activation proceeds along pathways lengthened by branching and merging bundles of surviving myocytes ensheathed by collagenous septa. |
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Authors:
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J M de Bakker; F J van Capelle; M J Janse; S Tasseron; J T Vermeulen; N de Jonge; J R Lahpor |
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Publication Detail:
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Type: In Vitro; Journal Article |
Journal Detail:
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Title: Circulation Volume: 88 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1993 Sep |
Date Detail:
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Created Date: 1993-09-23 Completed Date: 1993-09-23 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 915-26 Citation Subset: AIM; IM |
Affiliation:
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Interuniversity Cardiology Institute of The Netherlands, Department of Experimental Cardiology, Academic Medical Center, Amsterdam. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Electrocardiography
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methods Heart Conduction System / pathology, physiopathology* Humans Myocardial Infarction / complications, physiopathology* Papillary Muscles / pathology*, physiopathology Signal Processing, Computer-Assisted Tachycardia, Ventricular / etiology, physiopathology* |
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