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Electrophysiological measurements that can explain and guide temporary accelerated pacing to avert (re)occurrence of torsade de pointes arrhythmias in the canine chronic atrioventricular block model
- Source :
- Heart Rhythm, 14(5), 749. Elsevier
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background Pacing at higher rates is known to suppress torsade de pointes (TdP) arrhythmias. Nevertheless, exact application and mechanism need further clarification. In the anesthetized canine chronic atrioventricular block model, ventricular remodeling is responsible for a high and reproducible incidence of TdP upon a challenge with dofetilide. Objective We used this model to investigate by what mechanism accelerated pacing averts TdP and what repolarization parameter could be used to guide temporary accelerated pacing (TAP). Methods Ten dogs with repetitive TdP after administration of dofetilide when paced at 60 beats/min were selected. In a serial experiment, TAP was initiated at 100 beats/min after the first ectopic beat. Electrocardiogram and right and left ventricular (LV) monophasic action potential durations (MAPDs) were recorded. In a subset, vertical dispersion was determined with a duodecapolar catheter. Temporal dispersion was quantified as short-term variability (STV). Arrhythmias were quantified with the arrhythmia score. Results The increase in repolarization parameters observed after administration of dofetilide was counteracted by TAP (eg, LV MAPD from 381 ± 94 ms back to 310 ± 17 ms; P
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Ectopic beat
Torsades de pointes
Dofetilide
030204 cardiovascular system & hematology
03 medical and health sciences
Dogs
0302 clinical medicine
Heart Rate
Recurrence
Torsades de Pointes
Physiology (medical)
Internal medicine
Heart rate
Journal Article
medicine
Animals
Repolarization
Pacing
Atrioventricular Block
Ventricular remodeling
Torsade de pointes
Ventricular Remodeling
business.industry
Prevention
Cardiac Pacing, Artificial
Short-term variability
Dispersion
medicine.disease
Electrophysiological Phenomena
Disease Models, Animal
Electrophysiology
030104 developmental biology
Anesthesia
Chronic Disease
cardiovascular system
Cardiology
Electrophysiologic Techniques, Cardiac
Cardiology and Cardiovascular Medicine
business
Atrioventricular block
medicine.drug
Subjects
Details
- ISSN :
- 15475271
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Heart Rhythm
- Accession number :
- edsair.doi.dedup.....214e5c6d3f1a9f9c9eba67fb56312890