Rate disparity of near‐field versus far‐field ICD electrograms: A clue to the diagnosis of dissimilar ventricular rhythms

Kucher, Andreas; Barold, S. Serge

doi:10.1111/pace.13142

Cited by 2 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whilst dissimilar ventricular rhythms have been clinically observed and reported, there is no explanation for the underlying mechanism by which they occur. Intraventricular conduction block has been postulated as a possible mechanism (6, 8). The RV and LV have been shown to differ in their APD restitution response and ionic currents (9) and this may offer some explanation for the mechanism underlying dissimilar ventricular rhythms.…”

Section: Introductionmentioning

confidence: 99%

Interventricular Differences in Action Potential Duration Restitution Contribute to Dissimilar Ventricular Rhythms in ex vivo Perfused Hearts

Handa

Lawal

Wright

et al. 2019

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Background: Dissimilar ventricular rhythms refer to the occurrence of different ventricular tachyarrhythmias in the right and left ventricles or different rates of the same tachyarrhythmia in the two ventricles. Objective: We investigated the inducibility of dissimilar ventricular rhythms, their underlying mechanisms, and the impact of anti-arrhythmic drugs (lidocaine and amiodarone) on their occurrence. Methods: Ventricular tachyarrhythmias were induced with burst pacing in 28 Langendorff-perfused Sprague Dawley rat hearts (14 control, 8 lidocaine, 6 amiodarone) and bipolar electrograms recorded from the right and left ventricles. Fourteen (6 control, 4 lidocaine, 4 amiodarone) further hearts underwent optical mapping of transmembrane voltage to study interventricular electrophysiological differences and mechanisms of dissimilar rhythms. Results: In control hearts, dissimilar ventricular rhythms developed in 8/14 hearts (57%). In lidocaine treated hearts, there was a lower cycle length threshold for developing dissimilar rhythms, with 8/8 (100%) hearts developing dissimilar rhythms in comparison to 0/6 in the amiodarone group. Dissimilar ventricular tachycardia (VT) rates occurred at longer cycle lengths with lidocaine vs. control (57.1 ± 7.9 vs. 36.6 ± 8.4 ms, p < 0.001). The ratio of LV:RV VT rate was greater in the lidocaine group than control (1.91 ± 0.30 vs. 1.76 ± 0.36, p < 0.001). The gradient of the action potential duration (APD) restitution curve was shallower in the RV compared with LV (Control - LV: 0.12 ± 0.03 vs RV: 0.002 ± 0.03, p = 0.015), leading to LV-to-RV conduction block during VT. Conclusion: Interventricular differences in APD restitution properties likely contribute to the occurrence of dissimilar rhythms. Sodium channel blockade with lidocaine increases the likelihood of dissimilar ventricular rhythms.

show abstract

Section: Introductionmentioning

confidence: 99%

Interventricular Differences in Action Potential Duration Restitution Contribute to Dissimilar Ventricular Rhythms in ex vivo Perfused Hearts

Handa

Lawal

Wright

et al. 2019

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…However, it can only be a possible concept in CRT-D devices. It is unfortunately not applicable in the single- or dual-chamber ICDs because of the absence of LV sensing (3, 4). Further technical investigations in favor of a functioning hemodynamic sensor are possibly more promising as this would be applicable in all types of ICDs.…”

mentioning

confidence: 99%

Commentary: Interventricular Differences in Action Potential Duration Restitution Contribute to Dissimilar Ventricular Rhythms in ex vivo Perfused Hearts

Kucher

Stroobandt

2019

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

Rate disparity of near‐field versus far‐field ICD electrograms: A clue to the diagnosis of dissimilar ventricular rhythms

Cited by 2 publications

References 11 publications

Interventricular Differences in Action Potential Duration Restitution Contribute to Dissimilar Ventricular Rhythms in ex vivo Perfused Hearts

Interventricular Differences in Action Potential Duration Restitution Contribute to Dissimilar Ventricular Rhythms in ex vivo Perfused Hearts

Commentary: Interventricular Differences in Action Potential Duration Restitution Contribute to Dissimilar Ventricular Rhythms in ex vivo Perfused Hearts

Contact Info

Product

Resources

About