American journal of cardiology, ISSN 0002-9149 vol. 72, no. 16, November 1993
124F s. : tab., grafy ; 30 cm
- MeSH
- Anti-Arrhythmia Agents MeSH
- Arrhythmias, Cardiac MeSH
- Publication type
- Congress MeSH
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- kardiologie
- farmacie a farmakologie
- MeSH
- Potassium Channels MeSH
- Ergometry MeSH
- Molecular Structure MeSH
- Myocardium MeSH
- Prognosis MeSH
- Heart Ventricles MeSH
- Long QT Syndrome diagnosis genetics MeSH
- Publication type
- Review MeSH
BACKGROUND: Aim of the study was to find out which myocardial repolarization parameters predict reperfusion ventricular tachycardia and fibrillation (VT/VF) and determine how these parameters express in ECG. METHODS: Coronary occlusion and reperfusion (30/30min) was induced in 24 cats. Local activation and end of repolarization times (RT) were measured in 88 intramyocardial leads. Computer simulations of precordial electrograms were performed. RESULTS: Reperfusion VT/VF developed in 10 animals. Arrhythmia-susceptible animals had longer RTs in perfused areas [183(177;202) vs 154(140;170) ms in susceptible and resistant animals, respectively, P<0.05]. In logistic regression analysis, VT/VFs were associated with prolonged RTs in the perfused area (OR 1.068; 95% CI 1.012-1.128; P=0.017). Simulations demonstrated that prolonged repolarization in the perfused/border zone caused precordial terminal T-wave inversion. CONCLUSIONS: The reperfusion VT/VFs were independently predicted by the longer RT in the perfused zone, which was reflected in the terminal negative phase of the electrocardiographic T-wave.
- MeSH
- Electrocardiography * MeSH
- Ventricular Fibrillation physiopathology MeSH
- Cats MeSH
- Tachycardia, Ventricular physiopathology MeSH
- Disease Models, Animal MeSH
- Reperfusion Injury physiopathology MeSH
- Animals MeSH
- Check Tag
- Cats MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
xiii, 402 s. : il.
- MeSH
- Electrophysiology MeSH
- Electrocardiography MeSH
- Heart physiology MeSH
- Long QT Syndrome MeSH
- Publication type
- Monograph MeSH
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- kardiologie
INTRODUCTION: A variable proportion of non-responders to cardiac resynchronization therapy (CRT) warrants the search for new approaches to optimize the position of the left ventricular (LV) lead and the CRT device programming. CineECG is a novel ECG modality proposed for the spatial visualization and quantification of myocardial depolarization and repolarization sequences. OBJECTIVE: The present study aimed to evaluate CineECG-derived parameters in different pacing modes and to test their associations with acute hemodynamic responses in CRT patients. METHODS AND RESULTS: CineECG was used to construct the average electrical path within the cardiac anatomy from the 12-lead ECG. CineECG and LV dP/dt max were tested in 15 patients with nonischemic dilated cardiomyopathy and left bundle branch block (QRS: 170 ± 17 ms; LVEF: 26 ± 5.5%) under pacing protocols with different LV lead localizations. The CineECG-derived path directions were computed for the QRS and ST-T intervals for the anteroposterior (Xh), interventricular (Yh), and apicobasal (Zh) axes. In a multivariate linear regression analysis with adjustment for the pacing protocol type, the ST-T path direction Yh was independently associated with the increase in dP/dt max during CRT, [regression coefficient 639.4 (95% confidence interval: 187.9-1090.9), p = 0.006]. In ROC curve analysis, the ST-T path direction Yh was associated with the achievement of a 10% increase in dP/dt max (AUC: 0.779, p = 0.002) with the optimal cut-off > 0.084 (left-to-right direction) with sensitivity 0.67 and specificity 0.92. CONCLUSION: The acute hemodynamic response in CRT patients was associated with specific CineECG repolarization sequence parameters, warranting their further testing as potential predictors of clinical outcomes.
- MeSH
- Action Potentials MeSH
- Bundle-Branch Block * physiopathology therapy diagnosis MeSH
- Time Factors MeSH
- Cardiomyopathy, Dilated physiopathology therapy diagnosis MeSH
- Electrocardiography * MeSH
- Ventricular Function, Left * MeSH
- Hemodynamics * MeSH
- Middle Aged MeSH
- Humans MeSH
- Predictive Value of Tests * MeSH
- Cardiac Resynchronization Therapy Devices MeSH
- Aged MeSH
- Heart Rate MeSH
- Cardiac Resynchronization Therapy * MeSH
- Heart Failure physiopathology therapy diagnosis MeSH
- Stroke Volume MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
