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Dispersion of repolarization following double and triple programmed stimulation. A clinical study using the monophasic action potential recording technique

Yuan, S LU ; Blomström-Lundqvist, C; Pehrson, S LU ; Pripp, C M; Wohlfart, B LU and Olsson, Bertil LU (1996) In European Heart Journal 17(7). p.91-1080
Abstract

To study the dispersion of ventricular repolarization following double and triple programmed stimulation and its correlation with the inducibility of ventricular arrhythmias, monophasic action potentials were simultaneously recorded from the right ventricular apex and outflow tract during programmed stimulation in 12 patients with ventricular arrhythmias and a normal QT interval. The time difference between the ends of the two monophasic action potentials were used as a measure of the dispersion of ventricular repolarization, which consists of the activation time difference and the monophasic action potential duration difference. During double and triple programmed stimulation, the dispersion of ventricular repolarization increased... (More)

To study the dispersion of ventricular repolarization following double and triple programmed stimulation and its correlation with the inducibility of ventricular arrhythmias, monophasic action potentials were simultaneously recorded from the right ventricular apex and outflow tract during programmed stimulation in 12 patients with ventricular arrhythmias and a normal QT interval. The time difference between the ends of the two monophasic action potentials were used as a measure of the dispersion of ventricular repolarization, which consists of the activation time difference and the monophasic action potential duration difference. During double and triple programmed stimulation, the dispersion of ventricular repolarization increased significantly with the shortening of the coupling interval but decreased slightly with the shortening of the preceding interval. The induction of the ventricular arrhythmias in these patients was invariably associated with a marked increase in the dispersion of ventricular repolarization. The maximal dispersion of ventricular repolarization was significantly larger in the seven patients with polymorphic ventricular tachycardia and/or ventricular flutter/fibrillation induced than in the four patients with monomorphic ventricular tachycardia induced. Analysis of the two components of the dispersion of ventricular repolarization revealed that the increased dispersion of ventricular repolarization was mainly caused by an increase in the activation time difference in the monomorphic ventricular tachycardia subgroup, and by increases in both the activation time difference and monophasic action potential duration difference in the polymorphic ventricular tachycardia/fibrillation subgroup. These findings suggest that increased dispersion of ventricular repolarization is one of the underlying mechanisms accounting for the myocardial vulnerability to ventricular arrhythmias and that repolarization disturbance is important for the genesis of polymorphic ventricular tachycardia/fibrillation.

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published
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keywords
Action Potentials, Adult, Aged, Electric Stimulation, Female, Heart Conduction System, Humans, Male, Middle Aged, Refractory Period, Electrophysiological, Tachycardia, Ventricular, Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
in
European Heart Journal
volume
17
issue
7
pages
91 - 1080
publisher
Oxford University Press
external identifiers
  • Scopus:0029987252
ISSN
0195-668X
language
English
LU publication?
yes
id
e4fa5a07-8de1-40bb-acaa-67cc84f6f511
alternative location
http://eurheartj.oxfordjournals.org/content/17/7/1080.long
date added to LUP
2016-11-10 17:21:17
date last changed
2016-11-28 15:40:01
@misc{e4fa5a07-8de1-40bb-acaa-67cc84f6f511,
  abstract     = {<p>To study the dispersion of ventricular repolarization following double and triple programmed stimulation and its correlation with the inducibility of ventricular arrhythmias, monophasic action potentials were simultaneously recorded from the right ventricular apex and outflow tract during programmed stimulation in 12 patients with ventricular arrhythmias and a normal QT interval. The time difference between the ends of the two monophasic action potentials were used as a measure of the dispersion of ventricular repolarization, which consists of the activation time difference and the monophasic action potential duration difference. During double and triple programmed stimulation, the dispersion of ventricular repolarization increased significantly with the shortening of the coupling interval but decreased slightly with the shortening of the preceding interval. The induction of the ventricular arrhythmias in these patients was invariably associated with a marked increase in the dispersion of ventricular repolarization. The maximal dispersion of ventricular repolarization was significantly larger in the seven patients with polymorphic ventricular tachycardia and/or ventricular flutter/fibrillation induced than in the four patients with monomorphic ventricular tachycardia induced. Analysis of the two components of the dispersion of ventricular repolarization revealed that the increased dispersion of ventricular repolarization was mainly caused by an increase in the activation time difference in the monomorphic ventricular tachycardia subgroup, and by increases in both the activation time difference and monophasic action potential duration difference in the polymorphic ventricular tachycardia/fibrillation subgroup. These findings suggest that increased dispersion of ventricular repolarization is one of the underlying mechanisms accounting for the myocardial vulnerability to ventricular arrhythmias and that repolarization disturbance is important for the genesis of polymorphic ventricular tachycardia/fibrillation.</p>},
  author       = {Yuan, S and Blomström-Lundqvist, C and Pehrson, S and Pripp, C M and Wohlfart, B and Olsson, Bertil},
  issn         = {0195-668X},
  keyword      = {Action Potentials,Adult,Aged,Electric Stimulation,Female,Heart Conduction System,Humans,Male,Middle Aged,Refractory Period, Electrophysiological,Tachycardia, Ventricular,Clinical Trial,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {7},
  pages        = {91--1080},
  publisher    = {ARRAY(0xda09720)},
  series       = {European Heart Journal},
  title        = {Dispersion of repolarization following double and triple programmed stimulation. A clinical study using the monophasic action potential recording technique},
  volume       = {17},
  year         = {1996},
}