Skip Navigation


Europace Advance Access originally published online on November 15, 2007
Europace 2008 10(1):40-45; doi:10.1093/europace/eum238
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
10/1/40    most recent
eum238v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Ahlberg, S. E.
Right arrow Articles by Morgan, J. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ahlberg, S. E.
Right arrow Articles by Morgan, J. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

PACING

Investigation of pacing site-related changes in global restitution dynamics by non-contact mapping

Sarah E. Ahlberg1, Arthur M. Yue2, Nicholas D. Skadsberg3, Paul R. Roberts2, Paul A. Iaizzo4,5,6 and John M. Morgan2,*

1 Cardio Vascular, Medtronic Inc., 7601 Northland Drive, Brooklyn Park, MN 55428, USA; 2 Wessex Cardiac Centre, Southampton General Hospital, Mailpoint 46, Tremona Road, Southampton SO16 6YD, UK; 3 CRDM, Medtronic, Inc, 8200 Coral Sea Street NE, Mounds View, MN 55112, USA; 4 Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA; 5 Department of Physiology, University of Minnesota, Minneapolis, MN 55455, USA; 6 Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA

Aims: The determination of dynamic changes in ventricular repolarization may provide insight into arrhythmogenic mechanisms as a consequence of pacing site. This study investigated acute pacing site effects on global characteristics of electrical restitution using high resolution, non-contact mapping (NCM).

Methods and results: Activation-recovery intervals (ARIs) were determined from reconstructed left ventricular electrograms by the NCM system and were analysed during pacing from the right atrial appendage (RAA, intrinsic), right ventricular apex (RVA), and right ventricular septum (RVS) with extrasystoles delivered at intermediate and short coupling intervals in anesthetized swine (n = 5). Electrical restitution curves were determined by the S1–S2 pacing protocol. Activation-recovery interval restitution slopes were determined by the overlapping linear segments regression method. Global distribution of repolarization was defined as the coefficient of variation of the ARIs during restitution. The maximum ARI slopes yielded by RVA pacing were significantly greater than RAA pacing (0.44 vs. 0.32; P < 0.05) and RVS pacing (0.44 vs. 0.37; P = 0.05). There was no significant difference between RAA and RVS pacing (0.32 vs. 0.37). The global distribution of ARIs during restitution from RVA pacing was significantly greater than RAA pacing (12.0 vs. 8.1%; P < 0.05).

Conclusion: Right ventricular apex pacing is associated with impaired global repolarization patterns compared to RAA and RVS. These observations support the hypothesis that RVA pacing may be associated with increased risk of ventricular arrhythmias compared to RVS pacing.

Key Words: Pacing, Mapping, Dynamics, Arrhythmia, Electrical restitution

* Corresponding authors. Tel: +44 23 8079 6240; fax: +44 23 8079 8942.E-mail address: jmm{at}cardiology.co.uk

Manuscript submitted 27 July 2007. Accepted after revision 1 October 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.