Electrocardiographic indexes of dispersion of ventricular repolarization: An isolated heart validation study

Zabel, Markus; Portnoy, Stuart; Franz, Michael R.

doi:10.1016/0735-1097(94)00446-w

Cited by 384 publications

(195 citation statements)

References 24 publications

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“…Various Although the TTC generally has a good prognosis and ventricular arrhythmias are quite rare (5), the severe prolongation of the QT interval is to be considered as a predictor for the risk of sudden death (8). Sudden death is also a complication of AN, particularly if complicated by cardiac involvement (12).…”

Section: The Pathogenesis Of the Ttc Is Not Clear But Multivessel Epimentioning

confidence: 99%

Tako-tsubo Cardiomyopathy Complicated by Recurrent Torsade de Pointes in a Patient with Anorexia Nervosa

et al. 2010

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Section: The Pathogenesis Of the Ttc Is Not Clear But Multivessel Epimentioning

confidence: 99%

Tako-tsubo Cardiomyopathy Complicated by Recurrent Torsade de Pointes in a Patient with Anorexia Nervosa

et al. 2010

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“…33 Other noninvasive measures of repolarization abnormalities such as QT dispersion, QT dynamicity and T-wave alternans could also be used to assess overall vulnerability to arrhythmias. 34,35 …”

Section: Determining Arrhythmic Riskmentioning

confidence: 99%

Cardiac Resynchronization Therapy and its Potential Proarrhythmic Effect

Ray¹,

Fendelander²,

Singh³

2007

Clinical Cardiology

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SummaryCardiac resynchronization therapy (CRT) has become an established adjunctive treatment to optimal pharmacologic therapy in patients with advanced chronic heart failure (CHF), diminished left ventricular (LV) function and intraventricular conduction delay. Although CRT has been shown to improve ventricular hemodynamics, quality of life and exercise capacity, there is some evidence that it may rarely potentiate ventricular arrhythmias. As CRT is considered for an expanded population of CHF patients, and left-sided pacing is considered as an option for pacemaker-indicated patients (potentially without defibrillator backup), the effect of these pacing modalities on the incidence of ventricular tachyarrhythmia must be systematically studied and mechanistically understood. Strategies to prospectively predict the proarrhythmic potential of LV epicardial pacing need to be developed, and therapy accordingly individualized. This review attempts to summarize the current information on proarrhythmia in resynchronization therapy.

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“…Variability of the QT interval provides a measure of pro-arrhythmic electrical instability [18,19] . The QT interval was the time from the initial deflection from the isoelectric PR segment to the point at which voltage returned to the isoelectric TP segment.…”

Section: Qtc Interval Variabilitymentioning

confidence: 99%

“…Pyruvate stabilizes cardiac electrical function: role of ATP: ADP ratio Victims of hemorrhage are at risk of developing cardiac electrical instability [47] which can be monitored by assessing QTc variability [18,[48][49][50] . ROS have been implicated in the pathogenesis of arrhythmias, and it has been suggested that the antioxidative properties of certain medications could suppress ROS-mediated arrhythmogenesis [40] .…”

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confidence: 99%

Pyruvate-fortified resuscitation stabilizes cardiac electrical activity and energy metabolism during hypovolemia

Gurji

White

Hoxha

et al. 2013

WJCCM

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AIM:To test the hypothesis that fluid resuscitation with Ringer's solution enriched with pyruvate (PR), a physiological antioxidant and energy substrate, affords protection of myocardial metabolism and electrophysiological performance superior to lactated Ringer's (LR) during hypovolemia and hindlimb ischemia-reperfusion. METHODS:Male domestic goats (25-30 kg) were exsanguinated to a mean arterial pressure of 48 ± 1 mmHg. Right hindlimb ischemia was imposed for 90 min by applying a tourniquet and femoral crossclamp.LR or PR, infused iv , delivered 0.05 mmol/kg per minute L -lactate or pyruvate, respectively, from 30 min hindlimb ischemia until 30 min post-ischemia. Time controls (TC) underwent neither hemorrhage, hindlimb ischemia nor resuscitation. Goats were sacrificed and left ventricular myocardium biopsied at 90 min fluid resuscitation (n = 6 per group) or 3.5 h later (n = 9 LR, 10 PR, 8 TC). RESULTS:Myocardial 8-isoprostane content, phosphocreatine phosphorylation potential, creatine kinase activity, and heart rate-adjusted QT interval (QTc) variability were evaluated at 90 min resuscitation and 3.5 h post-resuscitation. PR sharply lowered pro-arrhythmic QTc variability vs LR (P < 0.05); this effect persisted 3.5 h post-resuscitation. PR lowered myocardial 8-isoprostane content, a product of oxidative stress, by 39 and 37% during and 3.5 h after resuscitation, respectively, vs LR. Creatine kinase activity fell 42% post-LR vs TC (P < 0.05), but was stable post-PR (P < 0.02 vs post-LR).PR doubled phosphocreatine phosphorylation potential, a measure of ATP free energy state, vs TC and LR (P < 0.05); this energetic enhancement persisted 3.5 h post-resuscitation. Core tip: In goats subjected to exsanguination-induced hypovolemia and tourniquet-imposed hindlimb ischemia-reperfusion, intravenous resuscitation with Ringer's lactate produced marked electrocardiographic instability, lipid peroxidation and inactivation of the critical creatine kinase system, which supplies energy for membrane ion transport. In comparison with lactated Ringer's, resuscitation enriched with the natural antioxidant and energy substrate pyruvate stabilized cardiac rhythm, prevented lipid peroxidation, preserved creatine kinase activity and augmented myocardial energy reserves. Importantly, these favorable effects persisted for at least 3.5 h after terminating pyruvateenriched resuscitation. Thus, pyruvate-enriched resuscitation prevented creatine kinase inactivation by oxidative stress, thereby preventing cardiac rhythm disturbances after central hypovolemia. CONCLUSION:Gurji HA, White DW, Hoxha B, Sun J, Olivencia-Yurvati AH, Mallet RT. Pyruvate-fortified resuscitation stabilizes cardiac electrical activity and energy metabolism during hypovolemia. World J Crit Care Med 2013; 2(4): 56-64 Available from: URL:

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Electrocardiographic indexes of dispersion of ventricular repolarization: An isolated heart validation study

Cited by 384 publications

References 24 publications

Tako-tsubo Cardiomyopathy Complicated by Recurrent Torsade de Pointes in a Patient with Anorexia Nervosa

Tako-tsubo Cardiomyopathy Complicated by Recurrent Torsade de Pointes in a Patient with Anorexia Nervosa

Cardiac Resynchronization Therapy and its Potential Proarrhythmic Effect

Pyruvate-fortified resuscitation stabilizes cardiac electrical activity and energy metabolism during hypovolemia

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