JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
 QUICK SEARCH:   [advanced]


     


J Am Coll Cardiol, 2005; 46:1067-1075, doi:10.1016/j.jacc.2005.05.074 (Published online 7 September 2005).
© 2005 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2005.05.074v3
46/6/1067    most recent
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 Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (15)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Yue, A. M.
Right arrow Articles by Morgan, J. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yue, A. M.
Right arrow Articles by Morgan, J. M.

CLINICAL RESEARCH: CARDIAC RHYTHM DISORDERS

Global Endocardial Electrical Restitution in Human Right and Left Ventricles Determined by Noncontact Mapping

Arthur M. Yue, MRCP*, Michael R. Franz, MD, PhD{dagger}, Paul R. Roberts, MD, MRCP* and John M. Morgan, MD, FRCP*,*

* Wessex Cardiac Center, Southampton General Hospital, Southampton, United Kingdom
{dagger} Cardiology Division, Veteran Affairs Medical Center, Washington, DC.

Manuscript received March 10, 2005; revised manuscript received May 12, 2005, accepted May 31, 2005.

* Reprint requests and correspondence: Dr. John M. Morgan, Wessex Cardiac Center, Southampton General Hospital, Mailpoint 46, Southampton SO16 6YD, United Kingdom. (Email: jmm{at}cardiology.co.uk).

OBJECTIVES: This study was aimed at evaluating global characteristics of electrical restitution in the human ventricle using noncontact mapping.

BACKGROUND: Steep action potential restitution (slope >1) and conduction velocity (CV) restitution have been linked with propensity to ventricular fibrillation, but clinical measurement of global electrical restitution had not been feasible.

METHODS: Activation-recovery interval (ARI) and CV restitution curves were simultaneously constructed from 16 regional segments of the left and right ventricles in 8 patients (6 male, 2 female, age 42 ± 17 years) following successful ablation of idiopathic ventricular tachycardia in the absence of structural disease guided by the Ensite 3000 system (Endocardial Solutions Inc., St. Paul, Minnesota). The ARIs were determined from reconstructed unipolar electrograms as validated with monophasic action potential recordings. The ARI restitution slopes were determined using the overlapping least-squares linear segments.

RESULTS: Global electrical restitution curves were heterogeneous in shape and distribution. ARI restitution slope was >1 at 25% of 128 sites. The overall mean slope was 0.79 and was greater in the left than the right ventricle (0.93 ± 0.49 vs. 0.65 ± 0.26, p < 0.001). Dispersion of ARI restitution slopes increased with decreasing diastolic intervals. The CV restitution operated over a narrower range of diastolic intervals compared with ARI restitution, reaching a plateau (10 ± 6 ms vs. 38 ± 13 ms, p < 0.001) after refractoriness. The magnitude of CV restitution was also greater (steeper) than ARI restitution (25 ± 10% vs. 18 ± 9%, p < 0.001).

CONCLUSIONS: Noncontact mapping can be used to examine global electrical restitution in the human ventricle. The ARI restitution is heterogeneous, with a slope >1 at 25% of all sites. The heterogeneity of ARI and CV restitution may be important in determining myocardial electrical stability.

Abbreviations and Acronyms
  APD = action potential duration
  ARI = activation-recovery interval
  AT = activation time
  CV = conduction velocity
  LV = left ventricle
  RT = repolarization time
  RV = right ventricle
  UE = unipolar electrogram
  VF = ventricular fibrillation




This article has been cited by other articles:


Home page
J Am Coll CardiolHome page
R. J. Selvaraj and V. S. Chauhan
Human Ventricular Action Potential Duration Restitution
J. Am. Coll. Cardiol., April 29, 2008; 51(17): 1721 - 1722.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. M. Narayan and M. R. Franz
Reply
J. Am. Coll. Cardiol., April 29, 2008; 51(17): 1722 - 1723.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. Hayashi, S. Takatsuki, P. Maison-Blanche, A. Messali, A. Haggui, P. Milliez, A. Leenhardt, and F. Extramiana
Ventricular Repolarization Restitution Properties in Patients Exhibiting Type 1 Brugada Electrocardiogram With and Without Inducible Ventricular Fibrillation
J. Am. Coll. Cardiol., March 25, 2008; 51(12): 1162 - 1168.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Heart Circ. Physiol.Home page
R. H. Keldermann, K. H. W. J. ten Tusscher, M. P. Nash, R. Hren, P. Taggart, and A. V. Panfilov
Effect of heterogeneous APD restitution on VF organization in a model of the human ventricles
Am J Physiol Heart Circ Physiol, February 1, 2008; 294(2): H764 - H774.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
A R Lyon, M Sato, R J Hajjar, R J Samulski, and S E Harding
Gene therapy: targeting the myocardium
Heart, January 1, 2008; 94(1): 89 - 99.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
S. E. Ahlberg, A. M. Yue, N. D. Skadsberg, P. R. Roberts, P. A. Iaizzo, and J. M. Morgan
Investigation of pacing site-related changes in global restitution dynamics by non-contact mapping
Europace, January 1, 2008; 10(1): 40 - 45.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. M. Narayan, M. R. Franz, G. Lalani, J. Kim, and A. Sastry
T-Wave Alternans, Restitution of Human Action Potential Duration, and Outcome
J. Am. Coll. Cardiol., December 18, 2007; 50(25): 2385 - 2392.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Heart Circ. Physiol.Home page
R. J. Selvaraj, P. Picton, K. Nanthakumar, and V. S. Chauhan
Steeper restitution slopes across right ventricular endocardium in patients with cardiomyopathy at high risk of ventricular arrhythmias
Am J Physiol Heart Circ Physiol, March 1, 2007; 292(3): H1262 - H1268.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
A. M. Yue, M. L. Koller, S. K.G. Maier, W. R. Bauer, M. Meesmann, A. R. Gelzer, and R. F. Gilmour Jr
Letter Regarding Article by Koller et al, "Altered Dynamics of Action Potential Restitution and Alternans in Humans With Structural Heart Disease"
Circulation, March 21, 2006; 113(11): e462 - e462.
[Full Text] [PDF]


Home page
Exp PhysiolHome page
M. P. Nash, C. P. Bradley, P. M. Sutton, R. H. Clayton, P. Kallis, M. P. Hayward, D. J. Paterson, and P. Taggart
Whole heart action potential duration restitution properties in cardiac patients: a combined clinical and modelling study
Exp Physiol, March 1, 2006; 91(2): 339 - 354.
[Abstract] [Full Text] [PDF]




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2005 by the American College of Cardiology Foundation.