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Ventricular Activation Pattern (ventricular + activation_pattern)

Distribution by Scientific Domains
Medical Sciences66%

Selected Abstracts

Variability in Postpacing Intervals Predicts Global Ventricular Activation Pattern during Tachycardia

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2 2010
ILYAS K. COLOMBOWALA M.D.
Introduction: Assessment of ventricular activation pattern is critical to the successful ablation of ventricular tachycardia (VT). We have previously shown that the global atrial activation pattern during tachycardia can be rapidly and accurately assessed by calculating the postpacing interval variability (PPIV); PPIV was minimal in circuitous tachycardias and highly variable in centrifugal tachycardias. In the present study, we use the PPIV to determine the ventricular global activation pattern during VT. Methods: Patients with mappable VT were included. We defined global ventricular activation as either centrifugal (arising from a focus with radial expansion) or circuitous (gross macro-reentrant circuit), based on the findings of electroanatomic mapping. PPIV was calculated as the difference in postpacing interval with right ventricular apical overdrive pacing during tachycardia at cycle lengths (CL) 10 ms and 30-ms shorter than tachycardia, regardless of the origin of the tachycardia. We studied 20 patients with 23 VTs (11 centrifugal, mean CL 390 ± 36.1 ms; 12 circuitous, mean CL 418 ± 75.7 ms). Results: The mean PPIV was 45 ± 16 ms for patients with centrifugal VT and 6.7 ± 4.1 ms for patients with circuitous VT. Rank sum analysis of PPIV showed a significant difference between the two groups (P < 0.05). Conclusions: Our data suggest that the global ventricular activation pattern during VT can be rapidly and accurately defined by assessing the PPIV. This technique allows for a rapid confirmation of the tachycardia activation and significantly facilitates mapping and ablation. (PACE 2010; 33:129,134) [source]

Laplacian Electrograms and the Interpretation of Complex Ventricular Activation Patterns During Ventricular Fibrillation

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2000
PH.D., RUBEN CORONEL M.D.
Laplacian Electrograms and Ventricular Fihrillation. Introduction. During ventricular fibrillation (VF) interpretation of a local electrogram and determination of the local activation moment are hampered by remote activity or intervening repolarization waves. Successful defibrillation depends on critical timing of the shock relative to local activation. We tested the applicabillity of Laplacian electrograms for detection of the moment of local activation during VF. Methods and Results. From isolated perfased porcine infact heart, 247 local unipolar electrograms were recorded simultaneously (13 × 19 matrix, interelectrode distance 0.3 mm) from the left ventricular wall during sinus rhythm, following pacing or during VF, Activation maps were constructed based on local unipolar electrograms, and Laplacian electrograms were calculated from local electrograms ane its eight neighbors. The Laplacian electrogram displayed a sharp R/S complex with local activation iodicted by the moment of zero crossing without interference from remote activity or repolarization waves. Its amplitude increased with decreasing interelectrode distance, Following epicardial stimulation, Laplacian amplitude was significantly larger than during complexes with different morphology. Collision of wavefronts was associated with entirely positive Laplacian waveforms; "focal" appearancce of acitivity was associated with an entirely negative waveform. Activation block in the activation maps was correlated with the appearance of substanined episodes of negativity or positivity in the Laplacian electrogram (depending on the location of the recording site relative to the line of block). Conclusion. Laplacian electrograms allow detection of the moment of local activation without interference from remote activity or repolarization, especially during complex arrhythmias. The technique applied toe automatic sensing devices, such its the internal defibrillator, may optimize defibrtilation success. (J Cardiovasc Electrophysiol, Vol. 11, pp. 1119-1128, October 2000) [source]

Variability in Postpacing Intervals Predicts Global Ventricular Activation Pattern during Tachycardia

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2 2010
ILYAS K. COLOMBOWALA M.D.
Introduction: Assessment of ventricular activation pattern is critical to the successful ablation of ventricular tachycardia (VT). We have previously shown that the global atrial activation pattern during tachycardia can be rapidly and accurately assessed by calculating the postpacing interval variability (PPIV); PPIV was minimal in circuitous tachycardias and highly variable in centrifugal tachycardias. In the present study, we use the PPIV to determine the ventricular global activation pattern during VT. Methods: Patients with mappable VT were included. We defined global ventricular activation as either centrifugal (arising from a focus with radial expansion) or circuitous (gross macro-reentrant circuit), based on the findings of electroanatomic mapping. PPIV was calculated as the difference in postpacing interval with right ventricular apical overdrive pacing during tachycardia at cycle lengths (CL) 10 ms and 30-ms shorter than tachycardia, regardless of the origin of the tachycardia. We studied 20 patients with 23 VTs (11 centrifugal, mean CL 390 ± 36.1 ms; 12 circuitous, mean CL 418 ± 75.7 ms). Results: The mean PPIV was 45 ± 16 ms for patients with centrifugal VT and 6.7 ± 4.1 ms for patients with circuitous VT. Rank sum analysis of PPIV showed a significant difference between the two groups (P < 0.05). Conclusions: Our data suggest that the global ventricular activation pattern during VT can be rapidly and accurately defined by assessing the PPIV. This technique allows for a rapid confirmation of the tachycardia activation and significantly facilitates mapping and ablation. (PACE 2010; 33:129,134) [source]

Abnormal Myocardial and Coronary Vasculature Development in Experimental Hypoxia

THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 10 2008
Ondrej Nanka
Freshly isolated quail embryonic heart at Hamburger-Hamilton stage 28, stained with voltage sensitive dye and optically mapped to reveal ventricular activation pattern (indicated by color isochrones in 1 ms intervals). The activation wave sweeps from left to right in the direction of the arrow. Maturation of ventricular activation patterns is accelerated by hypoxic incubation, as described in detail together with other changes in ventricular angio- and myoarchitecture. From "Abnormal Myocardial and coronary Vasculature Development in Experimental Hypoxia," by Ondrej Nanka, et al., on page 1187, in this issue. [source]