Effects of postshock atrial pacing on atrial defibrillation outcome in the isolated sheep heart

Circulation
A SkanesJ Jalife

Abstract

Failed atrial defibrillation shocks are associated with organization of postshock activity and a substantial postshock electrical quiescence. We investigated the ability of a train of pacing stimuli to capture or locally entrain atrial myocardium during the quiescent period after low-energy shocks and to alter defibrillation outcome. High-resolution video imaging of near-defibrillation-threshold atrial shocks was performed in 12 Langendorff-perfused sheep hearts. A train of 10 pacing stimuli (10-ms pulse width, 200-ms cycle length) was coupled to the shock at various delays in 7 hearts. Coupling intervals of 40 to 130 ms were investigated for feasibility of capture of the first pacing stimulus. The success rate of capture was 0, 0.08+/-0.08, 0.43+/-0.13, 0.73+/-0.13, and 0.11+/-0.1 for 40-, 60-, 80-, 100-, and 120-ms coupling intervals, respectively (P<0.001). In 5 experiments, the coupling interval was fixed at 100 ms (highest success, see above), and the pacing stimulus amplitude was varied between 1.0, 2.0, and 4.0 V. Successful capture rates were 0.38+/-0.08, 0.75+/-0.08, and 0.64+/-0.08, respectively (P<0.003 for 1.0 versus 2.0 V, P=0.2 for 2.0 versus 4.0 V). Rates of successful defibrillation for the groups without and wi...Continue Reading

References

Sep 1, 1992·Journal of the American College of Cardiology·A C PowellJ N Ruskin
Nov 1, 1991·Pacing and Clinical Electrophysiology : PACE·K KumagaiK Arakawa
Aug 1, 1990·Journal of the American College of Cardiology·K KumagaiK Arakawa
Mar 1, 1989·The Journal of Clinical Investigation·D W FrazierR E Ideker
Aug 1, 1988·Journal of the American College of Cardiology·S LevyP Bru

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Citations

Dec 30, 1998·Journal of Cardiovascular Electrophysiology·J JalifeD Vaidya
Oct 3, 2003·Journal of Cardiovascular Electrophysiology·Matthew W Kay, Jack M Rogers
Apr 3, 2014·Physiological Reviews·Nicole SchmittSøren-Peter Olesen

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