Vol. 283, Issue 4, H1703-H1712, October 2002
Premature excitation and onset of reentrant ventricular
tachycardia
Edward J.
Ciaccio
Departments of Pharmacology and Biomedical Engineering, College of
Physicians and Surgeons, Columbia University, New York, New York
10032
It
was hypothesized that quantitative sinus rhythm electrogram
measurements could be used to predict conduction events that result
from premature stimulation and reentrant ventricular tachycardia inducibility. Sinus rhythm activation and electrogram-duration maps
were constructed from bipolar electrograms acquired at 196-312 sites in the epicardial border zone of 43 canine hearts (25 with and 18 without reentrant ventricular tachycardia inducible by premature
stimulation). From these maps, lines of electrical discontinuity, where
blocks would occur during premature excitation, were estimated. The
mean error in distance between the estimated and actual block lines of
premature excitation was 0.97 ± 0.49 cm. Based on the quantitative characteristics of the activation and
electrogram-duration maps and the longest block line that formed
during premature excitation, it was possible to predict whether reentry
would occur (sensitivity, 94.7%; specificity, 79.6%). In reentry
experiments, the breakthrough-point location along the unidirectional
arc of the block that initiated reentry was also predictable (mean
error, 0.79 ± 0.19 cm). Sinus rhythm measurements are useful to
predict conduction events that result from premature stimulation and
reentry inducibility.
activation; reentry; sinus rhythm
