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The dispersion of repolarization in patients with ventricular tachycardia. A study using simultaneous monophasic action potential recordings from two sites in the right ventricle

Yuan, S LU ; Wohlfart, B LU ; Olsson, Bertil LU and Blomström-Lundqvist, C (1995) In European Heart Journal 16(1). p.68-76
Abstract

The role of increased dispersion of repolarization in the genesis of torsade de pointes and ventricular fibrillation has been well recognized generally, but not in the genesis of monomorphic ventricular tachycardia (VT). Monophasic action potentials (MAP) were therefore recorded simultaneously from the right ventricular (RV) apex (RVA) and outflow tract (RVOT) during sinus rhythm, RV pacing and programmed extra stimulation (PES) in 24 patients with VT. The activation time (AT), MAP duration at 90% repolarization (MAPd), and repolarization time (RT) were measured and their dispersions, defined as the differences in these parameters between RVA and RVOT, were calculated. During sinus rhythm and RV pacing, the dispersions of AT, MAPd and... (More)

The role of increased dispersion of repolarization in the genesis of torsade de pointes and ventricular fibrillation has been well recognized generally, but not in the genesis of monomorphic ventricular tachycardia (VT). Monophasic action potentials (MAP) were therefore recorded simultaneously from the right ventricular (RV) apex (RVA) and outflow tract (RVOT) during sinus rhythm, RV pacing and programmed extra stimulation (PES) in 24 patients with VT. The activation time (AT), MAP duration at 90% repolarization (MAPd), and repolarization time (RT) were measured and their dispersions, defined as the differences in these parameters between RVA and RVOT, were calculated. During sinus rhythm and RV pacing, the dispersions of AT, MAPd and RT (dispersions) were significantly larger in the 17 patients with a VT induced than in those without. During PES, the dispersions were further augmented in the S2 beats in the seven patients with a sustained VT induced, the maximal dispersion of RT being 85 +/- 22 ms. Both the dispersion of AT and that of MAPd contributed to the dispersion of RT. In both of our two patients with a sustained VT induced during MAP recording, a marked increase in dispersions of RT (140 and 190 ms, respectively) was observed immediately before the initiation of the VT. A link between the dispersions and the inducibility of a monomorphic VT was found in our patients, which suggests that the increased dispersions play an important role in the genesis of a monomorphic VT.

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author
organization
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Contribution to journal
publication status
published
keywords
Action Potentials, Adult, Aged, Cardiac Pacing, Artificial, Electrocardiography, Female, Humans, Male, Middle Aged, Tachycardia, Ventricular, Ventricular Function, Right, Journal Article, Research Support, Non-U.S. Gov't
in
European Heart Journal
volume
16
issue
1
pages
68 - 76
publisher
Oxford University Press
external identifiers
  • Scopus:0028934904
ISSN
0195-668X
DOI
10.1093/eurheartj/16.1.68
language
English
LU publication?
yes
id
cc05a72d-882d-45c3-a556-bbeef1a1f66c
date added to LUP
2016-11-10 17:23:58
date last changed
2016-11-23 09:20:50
@misc{cc05a72d-882d-45c3-a556-bbeef1a1f66c,
  abstract     = {<p>The role of increased dispersion of repolarization in the genesis of torsade de pointes and ventricular fibrillation has been well recognized generally, but not in the genesis of monomorphic ventricular tachycardia (VT). Monophasic action potentials (MAP) were therefore recorded simultaneously from the right ventricular (RV) apex (RVA) and outflow tract (RVOT) during sinus rhythm, RV pacing and programmed extra stimulation (PES) in 24 patients with VT. The activation time (AT), MAP duration at 90% repolarization (MAPd), and repolarization time (RT) were measured and their dispersions, defined as the differences in these parameters between RVA and RVOT, were calculated. During sinus rhythm and RV pacing, the dispersions of AT, MAPd and RT (dispersions) were significantly larger in the 17 patients with a VT induced than in those without. During PES, the dispersions were further augmented in the S2 beats in the seven patients with a sustained VT induced, the maximal dispersion of RT being 85 +/- 22 ms. Both the dispersion of AT and that of MAPd contributed to the dispersion of RT. In both of our two patients with a sustained VT induced during MAP recording, a marked increase in dispersions of RT (140 and 190 ms, respectively) was observed immediately before the initiation of the VT. A link between the dispersions and the inducibility of a monomorphic VT was found in our patients, which suggests that the increased dispersions play an important role in the genesis of a monomorphic VT.</p>},
  author       = {Yuan, S and Wohlfart, B and Olsson, Bertil and Blomström-Lundqvist, C},
  issn         = {0195-668X},
  keyword      = {Action Potentials,Adult,Aged,Cardiac Pacing, Artificial,Electrocardiography,Female,Humans,Male,Middle Aged,Tachycardia, Ventricular,Ventricular Function, Right,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {1},
  pages        = {68--76},
  publisher    = {ARRAY(0xbad8180)},
  series       = {European Heart Journal},
  title        = {The dispersion of repolarization in patients with ventricular tachycardia. A study using simultaneous monophasic action potential recordings from two sites in the right ventricle},
  url          = {http://dx.doi.org/10.1093/eurheartj/16.1.68},
  volume       = {16},
  year         = {1995},
}