Abstract
The mechanisms by which ventricular fibrillation (VF) is initiated in the infarcted human heart have not been defined. Left ventricular noncontact mapping of 8 episodes of pacing-induced VF in 6 patients (age 64.8+/-7.9 years, with previous myocardial infraction and left ventricular ejection fraction of 36+/-4%) undergoing ventricular tachycardia (VT) ablation revealed a consistent mechanism of VF induction. Whether during VT or sinus rhythm, the first of a train of paced extrastimuli to capture the LV produced an arc or arcs of functional block at regions bordering scar. With subsequent extrastimuli, the arcs elongated to circumscribe an enlarging area of increasingly late activation, with reentry through part of this functional (unidirectional) block leading to wavefront fragmentation and VF. These regions had longer fibrillation intervals (263+/-63 ms) than remote LV regions (209+/-23.4 ms; P<0.0001), implying longer refractory periods, and in 6 of the 8 VF episodes, these regions correlated with VT exit sites. In each of the 2 patients with 2 episodes of VF, both episodes formed arcs of functional block in the same location, despite pacing from different sites. Pacing-induced VF in the infarcted human heart is initiated by ...Continue Reading
References
Apr 1, 1976·British Heart Journal·N El-SherifR Lazzara
Oct 1, 1979·The American Journal of Cardiology·M E JosephsonL N Horowitz
Jan 23, 1992·Nature·J M DavidenkoJ Jalife
Jan 1, 1990·Annals of the New York Academy of Sciences·V S Zykov
Feb 1, 1988·British Heart Journal·S BekheitN el-Sherif
Jul 1, 1988·Circulation Research·S M DillonA L Wit
Mar 1, 1987·The American Journal of Cardiology·M ZehenderH J Wellens
Jan 1, 1982·British Heart Journal·A A AdgeyH C Mulholland
Nov 1, 1983·Journal of the American College of Cardiology·C M PrattM A Quinones
Oct 1, 1994·Journal of Electrocardiology·H Käsmacher-Leidinger, H Schmid-Schönbein
Dec 1, 1995·Acta Biotheoretica·A L BardouM C Govaere
Feb 1, 1997·Cardiovascular Research·V G Fast, A G Kléber
Mar 24, 1998·Nature·F X WitkowskiA T Winfree
Jul 2, 1998·Biophysical Journal·J BeaumontJ Jalife
Oct 24, 1998·Journal of Cardiovascular Electrophysiology·R J SchillingN S Peters
Nov 3, 2000·Current Cardiology Reports·A W ChowD W Davies
May 8, 2002·Circulation·Anthony W C ChowNicholas S Peters
Aug 21, 2002·Circulation·Michel HaïssaguerreJacques Clémenty
Citations
Jan 29, 2011·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Gabriel Decebal LatcuPhilippe Maury
Mar 21, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Vern Hsen TanReginald Liew
Mar 27, 2012·American Journal of Physiology. Heart and Circulatory Physiology·Ohad ZivGideon Koren
Dec 20, 2011·Revista Española De Cardiología·Francisco J ChorroLuis Such
Nov 24, 2005·Journal of Cardiovascular Electrophysiology·Nicholas S Peters
Nov 9, 2005·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Jianhua CuiKeith A Robinson
Apr 21, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Oliver R SegalD Wyn Davies
May 17, 2015·Computers in Biology and Medicine·C D CantwellN S Peters
Mar 31, 2007·Journal of the American College of Cardiology·Oliver R SegalNicholas S Peters
Feb 5, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Oliver R SegalD Wyn Davies
Aug 6, 2016·Expert Review of Cardiovascular Therapy·Jason T JacobsonWilbert Aronow
May 15, 2015·Postgraduate Medicine·Jason T JacobsonWilbert Aronow
Jul 1, 2009·Circulation·P D LambiaseW J McKenna
Jul 7, 2005·Circulation·Stuart P ThomasDavid L Ross
Oct 2, 2009·Physical Review. E, Statistical, Nonlinear, and Soft Matter Physics·Trine Krogh-Madsen, David J Christini
Nov 9, 2005·Progress in Cardiovascular Nursing·Christine ThompsonAmin Al-Ahmad
Nov 18, 2010·Cardiovascular Engineering·Sharon Zlochiver