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Investigation of pacing site-related changes in global restitution dynamics by non-contact mapping

Investigation of pacing site-related changes in global restitution dynamics by non-contact mapping
Investigation of pacing site-related changes in global restitution dynamics by non-contact mapping
Aims: the determination of dynamic changes in ventricular repolarization may provide insight into arrhythmogenic mechanisms as a consequence of pacing site. This study investigated acute pacing site effects on global characteristics of electrical restitution using high resolution, non-contact mapping (NCM).

Methods and results: activation-recovery intervals (ARIs) were determined from reconstructed left ventricular electrograms by the NCM system and were analysed during pacing from the right atrial appendage (RAA, intrinsic), right ventricular apex (RVA), and right ventricular septum (RVS) with extrasystoles delivered at intermediate and short coupling intervals in anesthetized swine (n = 5). Electrical restitution curves were determined by the S1-S2 pacing protocol. Activation-recovery interval restitution slopes were determined by the overlapping linear segments regression method. Global distribution of repolarization was defined as the coefficient of variation of the ARIs during restitution. The maximum ARI slopes yielded by RVA pacing were significantly greater than RAA pacing (0.44 vs. 0.32; P < 0.05) and RVS pacing (0.44 vs. 0.37; P = 0.05). There was no significant difference between RAA and RVS pacing (0.32 vs. 0.37). The global distribution of ARIs during restitution from RVA pacing was significantly greater than RAA pacing (12.0 vs. 8.1%; P < 0.05).

Conclusion: right ventricular apex pacing is associated with impaired global repolarization patterns compared to RAA and RVS. These observations support the hypothesis that RVA pacing may be associated with increased risk of ventricular arrhythmias compared to RVS pacing.
therapy, artificial, swine, hypothesis, heart atria, disease models, heart ventricles, arrhythmias, vascular, electrocardiography, methods, male, cardiac, risk factors, pacemaker, atrial appendage, linear models, etiology, physiopathology, research, risk, animal, animals, cardiac pacing
1099-5129
40-45
Ahlberg, Sarah E.
269273ef-23a1-467d-a1b9-524632e7303e
Yue, Arthur M.
4040f8ec-0252-49e0-b838-58f37956acd2
Skadsberg, Nicholas D.
86e32140-8447-4722-8ded-acd3fdcc9a1a
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
Iaizzo, Paul A.
5401d928-4a52-460d-8aed-93b291d4f3b8
Morgan, John M.
ac98099e-241d-4551-bc98-709f6dfc8680
Ahlberg, Sarah E.
269273ef-23a1-467d-a1b9-524632e7303e
Yue, Arthur M.
4040f8ec-0252-49e0-b838-58f37956acd2
Skadsberg, Nicholas D.
86e32140-8447-4722-8ded-acd3fdcc9a1a
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
Iaizzo, Paul A.
5401d928-4a52-460d-8aed-93b291d4f3b8
Morgan, John M.
ac98099e-241d-4551-bc98-709f6dfc8680

Ahlberg, Sarah E., Yue, Arthur M., Skadsberg, Nicholas D., Roberts, Paul R., Iaizzo, Paul A. and Morgan, John M. (2008) Investigation of pacing site-related changes in global restitution dynamics by non-contact mapping. Europace, 10 (1), 40-45. (doi:10.1093/europace/eum238).

Record type: Article

Abstract

Aims: the determination of dynamic changes in ventricular repolarization may provide insight into arrhythmogenic mechanisms as a consequence of pacing site. This study investigated acute pacing site effects on global characteristics of electrical restitution using high resolution, non-contact mapping (NCM).

Methods and results: activation-recovery intervals (ARIs) were determined from reconstructed left ventricular electrograms by the NCM system and were analysed during pacing from the right atrial appendage (RAA, intrinsic), right ventricular apex (RVA), and right ventricular septum (RVS) with extrasystoles delivered at intermediate and short coupling intervals in anesthetized swine (n = 5). Electrical restitution curves were determined by the S1-S2 pacing protocol. Activation-recovery interval restitution slopes were determined by the overlapping linear segments regression method. Global distribution of repolarization was defined as the coefficient of variation of the ARIs during restitution. The maximum ARI slopes yielded by RVA pacing were significantly greater than RAA pacing (0.44 vs. 0.32; P < 0.05) and RVS pacing (0.44 vs. 0.37; P = 0.05). There was no significant difference between RAA and RVS pacing (0.32 vs. 0.37). The global distribution of ARIs during restitution from RVA pacing was significantly greater than RAA pacing (12.0 vs. 8.1%; P < 0.05).

Conclusion: right ventricular apex pacing is associated with impaired global repolarization patterns compared to RAA and RVS. These observations support the hypothesis that RVA pacing may be associated with increased risk of ventricular arrhythmias compared to RVS pacing.

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More information

Published date: January 2008
Keywords: therapy, artificial, swine, hypothesis, heart atria, disease models, heart ventricles, arrhythmias, vascular, electrocardiography, methods, male, cardiac, risk factors, pacemaker, atrial appendage, linear models, etiology, physiopathology, research, risk, animal, animals, cardiac pacing

Identifiers

Local EPrints ID: 60858
URI: https://eprints.soton.ac.uk/id/eprint/60858
ISSN: 1099-5129
PURE UUID: 94300436-2c9d-466f-b18a-32d4666c2a4d

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Date deposited: 08 Sep 2008
Last modified: 13 Mar 2019 20:29

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Contributors

Author: Sarah E. Ahlberg
Author: Arthur M. Yue
Author: Nicholas D. Skadsberg
Author: Paul R. Roberts
Author: Paul A. Iaizzo
Author: John M. Morgan

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