First Postpacing Interval Variability During Right Ventricular Stimulation

Arenal, Ángel; Almendral, Jesús; Pérez-Villacastín, Julián; Morris, Raimundo; Castellanos, Eduardo; Delcán, Juan L.

doi:10.1161/01.cir.98.7.671

Cited by 6 publications

(1 citation statement)

References 25 publications

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“…The variability was approximately twice lower in the case of slow (TCL≥350 ms) tachycardias. Ninety-five percent of the first and second assessments in the clinical measurements differed from one another by Limits of Agreement=19.6 ms. Arenal et al 24 assessed the variability of the first PPI during right ventricular pacing to differentiate between ventricular and supraventricular tachycardias in patients with implantable cardioverter-defibrillators. In their study, they analyzed 23 relatively slow VTs (mean TCL, 366±50 ms) and demonstrated that the difference between 2 PPI measurements was below 10 and 20 ms in 90% and 100% of the measurements, respectively, which is comparable to our results.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Restitution Properties of Cardiac Tissue on the Repeatability of Entrainment Mapping Response

Derejko

Podziemski

Żebrowski

et al. 2014

Circ: Arrhythmia and Electrophysiology

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This prospective study comprised 30 patients (26 males, mean age = 55±16 years) referred for ablation of either atrial or ventricular © 2014 American Heart Association, Inc. Original Article Background-The difference between the postpacing interval (PPI) and the tachycardia cycle length (TCL; PPI−TCL) is a useful tool in mapping macro-reentrant tachycardias. However, entrainment pacing causes some perturbation of the conduction velocity within the tachycardia circuit, which may affect the repeatability and consequently the accuracy of the measurement of PPI−TCL. The aim of this study was to assess PPI−TCL repeatability both in vivo and in silico. Methods and Results-In the experimental part, entrainment pacing was performed twice at each of the 124 tested sites for 30 patients undergoing radiofrequency ablation of atrial and ventricular re-entrant arrhythmias. A similar protocol was used in a simplified computer model of the cardiac tachycardia circuit in a 2-dimensional tissue strip using a Fenton-Karma model of cardiac tissue. In vivo, in the case of fast tachycardias (<350 ms), PPI−TCL variability observed was doubled compared with slow tachycardias (>350 ms; 95% Limits of Agreement ranged from −21.4 to 21.6 ms for TCL<350 ms and from −10.8 to 11.5 ms for TCL>350 ms). Simulations show that this increase of variability may be because of the oscillations of the conduction velocity inside the tachycardia circuits. The effect of the restitution properties of cardiac tissue on the outcome of entrainment pacing is discussed. Conclusions-PPI−TCL is characterized by a high repeatability with the differences between the results for individual stimulations of ≤20 ms. The variability of this parameter is significantly lower in the case of slow tachycardias.(Circ Arrhythm Electrophysiol. 2014;7:497-504.)

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Section: Discussionmentioning

confidence: 99%