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Ventricular Electrogram (ventricular + electrogram)
Selected AbstractsDouble Counting of the Ventricular Electrogram in Biventricular Pacemakers and ICDsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 8 2003S. SERGE BAROLD First page of article [source] The VA Relationship After Differential Atrial Overdrive Pacing: A Novel Tool for the Diagnosis of Atrial Tachycardia in the Electrophysiologic LaboratoryJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 11 2007MITSUNORI MARUYAMA M.D. Introduction: Despite recent advances in clinical electrophysiology, diagnosis of atrial tachycardia (AT) originating near Koch's triangle remains challenging. We sought a novel technique for rapid and accurate diagnosis of AT in the electrophysiologic laboratory. Methods: Sixty-two supraventricular tachycardias including 18 ATs (10 ATs arising from near Koch's triangle), 32 atrioventricular nodal reentrant tachycardias (AVNRTs), and 12 orthodromic reciprocating tachycardias (ORTs) were studied. Overdrive pacing during the tachycardia from different atrial sites was performed, and the maximal difference in the postpacing VA intervals (last captured ventricular electrogram to the earliest atrial electrogram of the initial beat after pacing) among the different pacing sites was calculated (delta-VA interval). Results: The delta-VA intervals were >14 ms in all AT patients and <14 ms in all AVNRT/ORT patients, and thus, the delta-VA interval was diagnostic for AT with the sensitivity, specificity, and positive and negative predictive values all being 100%. When the diagnostic value of the delta-VA interval and conventional maneuvers were compared for differentiating AT from atypical AVNRT, both a delta-VA interval >14 ms and "atrial-atrial-ventricular" response after overdrive ventricular pacing during the tachycardia were diagnostic. However, the "atrial-atrial-ventricular" response criterion was available in only 52% of the patients because of poor ventriculoatrial conduction. Conclusions: The delta-VA interval was useful for diagnosing AT irrespective of patient conditions such as ventriculoatrial conduction. [source] A Segmental Polynomial Model of Ventricular Electrograms as a Simple and Efficient Morphology Discriminator for Implantable DevicesANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2006Jeffrey L. Williams M.D. Background: The goal of this study is to construct a polynomial model of the ventricular electrogram (EGM) that faithfully reproduces the EGM and can be implemented in current, low computational power implantable devices. Such a model of ventricular EGMs is still lacking. Methods: New Zealand White rabbits underwent chronic implantation of pacemakers through a left thoracotomy approach. Unipolar ventricular EGMs sampled at a frequency of 1 kHz were stored digitally in 1-minute segments before and after intravenous injection of isoproterenol or procainamide. Each cardiac cycle was divided into a QR and an RQ segment which were modeled separately using a 6th order polynomial equation. Results: The 14 coefficients of each cardiac cycle were reproducible throughout the baseline recordings (r , 0.94, P < 0.002). Isoproterenol caused no changes in the coefficients of the QR segment but significantly altered all but one of the seven coefficients of the RQ segment (p6= 0.0039, p5= 0.017, p4= 0.00007, p3= 0.112, p2= 0.00016, p1= 0.0086, pa= 0.00003). Procainamide caused statistically significant changes in both QR segment (p6= 0.018, p5= 0.287, p4= 0.019, p3= 0.176, p2= 0.016, p1= 0.362, pa= 0.000044) and RQ segment (p6= 0.0028, p5= 0.036, p4= 0.002, p3= 0.058, p2= 0.022, p1= 0.718, pa= 0.0018) coefficients. Conclusion: Our data demonstrate the feasibility of a segmental polynomial equation that reproduces the phases of depolarization and repolarization of the rabbit EGM. This model is reproducible and demonstrates the expected changes with antiarrhythmic drug administration. If reproduced in humans, these findings can have wide applications in patients with implantable devices, ranging from morphologic discrimination of arrhythmias to early detection of metabolic derangements or drug effects. [source] Maturational Atrioventricular Nodal Physiology in the MouseJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 5 2000COLIN T. MAGUIRE B.S. Mouse AV Nodal Maturation. Introduction: Dual AV nodal physiology is characterized by discontinuous conduction from the atrium to His bundle during programmed atrial extrastimulus testing (A2V2 conduction curves), AV nodal echo beats, and induction of AV nodal reentry tachycardia (AVNRT). The purpose of this study was to characterize in vivo murine maturational AV nodal conduction properties and determine the frequency of dual AV nodal physiology and inducible AVNRT. Methods and Results: A complete transvenous in vivo electrophysiologic study was performed on 30 immature and 19 mature mice. Assessment of AV nodal conduction included (1) surface ECG and intracardiac atrial and ventricular electrograms; (2) decremental atrial pacing to the point of Wenckebach block and 2:1 conduction; and (3) programmed premature atrial extrastimuli to determine AV effective refractory periods (AVERP), construct A2V2 conduction curves, and attempt arrhythmia induction. The mean Wenckebach block interval was 73 ± 12 msec, 2:1 block pacing cycle length was 61 ± 11 msec, and mean AVERP100 was 54 ± 11 msec. The frequency of dual AV nodal physiology increased with chronologic age, with discontinuous A2V2, conduction curves or AV nodal echo heats in 27% of young mice < 8 weeks and 58% in adult mice (P = 0.03). Conclusion: These data suggest that mice, similar to humans, have maturation of AV nodal physiology, hut they do not have inducible AVNRT. Characterization of murine electrophysiology may be of value in studying genetically modified animals with AV conduction abnormalities. Furthermore, extrapolation to humans may help explain the relative rarity of AVNRT in the younger pediatric population. [source] | ||||||||||