Dispersion of repolarization and arrhythmogenesis
- PMID: 19324316
- DOI: 10.1016/j.hrthm.2009.01.013
Dispersion of repolarization and arrhythmogenesis
Abstract
Background: The relation between induction of arrhythmias and dispersion of repolarization is not completely understood.
Objective: The purpose of this study was to study the relation between heterogeneity in repolarization and arrhythmogenesis under conditions of selective regional action potential prolongation and shortening.
Methods: Pig hearts were perfused in a Langendorff setup. The left anterior descending artery (LAD) was cannulated and perfused. Sotalol (220 microM) was infused in the aortic cannula, and pinacidil (20 microM) was infused through the LAD, causing a gradient in repolarization time between the two myocardial regions. Premature stimulation was performed from the LAD region.
Results: No transmural repolarization gradients developed after infusion of the drugs. High-density epicardial activation/repolarization mapping (176 unipolar electrodes, 2-mm interelectrode spacing) revealed a maximum repolarization gradient of approximately 120 ms over 14 mm. The critical parameter for differentiating between the occurrence of reentry and the mere occurrence of a line of activation block between the two myocardial regions (and no reentry) was not the magnitude of the repolarization gradient but the timing of arrival of the premature activation wave at the distal side of the line of activation block relative to the repolarization time of the premature beat proximal to the line of block. No spontaneous arrhythmias were observed despite the presence of the repolarization gradient.
Conclusion: It is not the repolarization gradient but the restitution characteristics of the tissue with the shorter action potential, in combination with the time of arrival of the premature wavefront at the distal side of the line of block, that determines the occurrence of reentry.
Comment in
-
Restitution, heterogeneity and unidirectional conduction block: New roles for old players.Heart Rhythm. 2009 Apr;6(4):544-5. doi: 10.1016/j.hrthm.2009.01.036. Epub 2009 Jan 31. Heart Rhythm. 2009. PMID: 19324317 No abstract available.
Similar articles
-
Restitution, heterogeneity and unidirectional conduction block: New roles for old players.Heart Rhythm. 2009 Apr;6(4):544-5. doi: 10.1016/j.hrthm.2009.01.036. Epub 2009 Jan 31. Heart Rhythm. 2009. PMID: 19324317 No abstract available.
-
Reduction of dispersion of repolarization and prolongation of postrepolarization refractoriness explain the antiarrhythmic effects of quinidine in a model of short QT syndrome.J Cardiovasc Electrophysiol. 2007 Jun;18(6):658-64. doi: 10.1111/j.1540-8167.2007.00813.x. J Cardiovasc Electrophysiol. 2007. PMID: 17521304
-
Electrophysiological profile of vernakalant in an experimental whole-heart model: the absence of proarrhythmia despite significant effect on myocardial repolarization.Europace. 2014 Aug;16(8):1240-8. doi: 10.1093/europace/euu014. Epub 2014 Apr 2. Europace. 2014. PMID: 24696223
-
Dispersion in ventricular repolarization in the human, canine and porcine heart.Prog Biophys Mol Biol. 2016 Jan;120(1-3):222-35. doi: 10.1016/j.pbiomolbio.2016.01.007. Epub 2016 Jan 11. Prog Biophys Mol Biol. 2016. PMID: 26790342 Review.
-
Repolarization gradients in the intact heart: transmural or apico-basal?Prog Biophys Mol Biol. 2012 May;109(1-2):6-15. doi: 10.1016/j.pbiomolbio.2012.03.001. Epub 2012 Mar 15. Prog Biophys Mol Biol. 2012. PMID: 22446189 Review.
Cited by
-
The electrical restitution of the non-propagated cardiac ventricular action potential.Pflugers Arch. 2024 Jan;476(1):9-37. doi: 10.1007/s00424-023-02866-0. Epub 2023 Oct 3. Pflugers Arch. 2024. PMID: 37783868 Free PMC article. Review.
-
Targeted activation of human ether-à-go-go-related gene channels rescues electrical instability induced by the R56Q+/- long QT syndrome variant.Cardiovasc Res. 2023 Nov 25;119(15):2522-2535. doi: 10.1093/cvr/cvad155. Cardiovasc Res. 2023. PMID: 37739930
-
The circle of reentry: Characteristics of trigger-substrate interaction leading to sudden cardiac arrest.Front Cardiovasc Med. 2023 Apr 17;10:1121517. doi: 10.3389/fcvm.2023.1121517. eCollection 2023. Front Cardiovasc Med. 2023. PMID: 37139119 Free PMC article.
-
Antiarrhythmic and Inotropic Effects of Selective Na+/Ca2+ Exchanger Inhibition: What Can We Learn from the Pharmacological Studies?Int J Mol Sci. 2022 Nov 24;23(23):14651. doi: 10.3390/ijms232314651. Int J Mol Sci. 2022. PMID: 36498977 Free PMC article. Review.
-
Repolarization Heterogeneity in Human Post-Infarct Ventricular Tachycardia.JACC Clin Electrophysiol. 2022 Jun;8(6):713-718. doi: 10.1016/j.jacep.2022.03.002. JACC Clin Electrophysiol. 2022. PMID: 35738846 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical