Kinetics of atrial repolarization alternans in a free-behaving ovine model.

Journal of Cardiovascular Electrophysiology
Florian JoussetEtienne J Pruvot

Abstract

Kinetics of Atrial Repolarization Alternans. Repolarization alternans (Re-ALT), a beat-to-beat alternation in action potential repolarization, promotes dispersion of repolarization, wavebreaks, and reentry. Recently, Re-ALT has been shown to play an important role in the transition from rapid pacing to atrial fibrillation (AF) in humans. The detailed kinetics of atrial Re-ALT, however, has not been reported so far. We developed a chronic free-behaving ovine pacing model to study the kinetics of atrial Re-ALT as a function of pacing rate. Thirteen sheep were chronically implanted with 2 pacemakers for the recording of broadband right atrial unipolar electrograms and delivery of rapid pacing protocols. Beat-to-beat differences in the atrial T-wave apex amplitude as a measure of Re-ALT and activation time were analyzed at incremental pacing rates until the effective refractory period (ERP) defined as stable 2:1 capture. Atrial Re-ALT appeared intermittently but without periodicity, and increased in amplitude as a function of pacing rate until ERP. Intermittent 2:1 atrial capture was observed at pacing cycle lengths 40 ms above ERP, and increased in duration as a function of pacing rate. Episodes of rapid pacing-induced AF were rar...Continue Reading

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Citations

Jun 24, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Rodolfo BonattiRichard L Verrier
Nov 26, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Richard L VerrierLuiz Belardinelli
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Jun 3, 2021·Journal of the American Heart Association·Kanchan KulkarniAntonis A Armoundas

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