Comparison of bipolar and unipolar programmed electrical stimulation for the initiation of ventricular arrhythmias: significance of anodal excitation during bipolar stimulation

Circulation
W G StevensonJ N Weiss

Abstract

To determine if anodal excitation during bipolar stimulation facilitates the initiation of sustained monomorphic ventricular tachycardia, nonsustained polymorphic ventricular tachycardia, or repetitive ventricular responses, both bipolar and cathodal unipolar programmed ventricular stimulation with one to three extrastimuli delivered during ventricular pacing at two rates from the right ventricular apex were performed in 28 patients evaluated for spontaneous sustained ventricular tachycardia or ventricular fibrillation (11 patients), nonsustained tachycardia (eight patients), or syncope (nine patients). In 25 patients a hexapolar pacing catheter was used to record local endocardial activation times adjacent to the cathode and anode and ventricular excitation during bipolar stimulation was defined as predominantly anodal, cathodal, or simultaneous at both anode and cathode. When bipolar and unipolar stimulation were compared there was no difference in the incidence of initiating sustained monomorphic ventricular tachycardia (57% vs 57%), nonsustained polymorphic ventricular tachycardia (14% vs 14%), or repetitive ventricular responses (21% vs 21%), although the response to bipolar vs unipolar stimulation was not concordant in ev...Continue Reading

References

Jul 1, 1977·American Heart Journal·S FurmanR Mehra
Mar 1, 1986·The American Journal of Cardiology·W G StevensonJ N Weiss
Jul 1, 1981·Circulation Research·B F Hoffman, M R Rosen
Aug 1, 1957·The American Journal of Physiology·P F CRANEFIELDA A SIEBENS

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Citations

Mar 4, 2005·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Corinna B BrunckhorstWilliam G Stevenson
Apr 1, 1990·Journal of Pharmacological Methods·G KrumplG Raberger
Jan 1, 1990·Experimental Gerontology·P U CarboninG Gambassi
Jan 1, 1988·Journal of the American College of Cardiology·M J CooperD L Ross
Jun 1, 1989·Journal of the American College of Cardiology·M J CooperD L Ross
Apr 1, 1990·Journal of the American College of Cardiology·A K BhandariS H Rahimtoola
Nov 14, 1997·The American Journal of Cardiology·M D Landers, M J Reiter
Sep 1, 1991·Pacing and Clinical Electrophysiology : PACE·A H KadishF Morady
Mar 3, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Michael O Sweeney, Frederick L Porkolab
Feb 1, 1988·Pacing and Clinical Electrophysiology : PACE·E N Prystowsky

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