Restitution dynamics during pacing and arrhythmias in isolated pig hearts

被引:70
作者
Banville, I
Chattipakorn, N
Gray, RA
机构
[1] Univ Alabama Birmingham, Dept Biomed Engn, Cardiac Rhythm Management Lab, Birmingham, AL 35294 USA
[2] Univ Alabama Birmingham, Dept Med, Birmingham, AL 35294 USA
关键词
alternans; ventricular fibrillation; restitution; memory; optical mapping;
D O I
10.1046/j.1540-8167.2004.03330.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: The dependence of action potential duration (APD) on the preceding diastolic interval (DI), i.e., restitution, has been purported to predict the development of alternans and reentrant arrhythmias. However, restitution depends on the history of activation (i.e., memory), and its relevance to arrhythmia induction and maintenance is unknown. Methods and Results: Using a dual-camera video imaging system, we recorded action potentials from thousands of sites on the surface of the isolated pig heart. A steady-state pacing (SSP) protocol was performed to generate the SSP APD restitution curve. During SSP, the minimum DI and APD were 57 +/- 6 ms and 107 +/- 6 ms, respectively. The restitution slope was >1 for DIs <85 +/- 5 ms; however, alternans were not observed. Abrupt decreases in cycle length (CL) resulted in a rapid (<5 beats) decrease in APD followed by a slower decrease to "steady state." DI, APD pairs for the initial beats following these rate changes were significantly above the SSP restitution curve. DI, APD pairs measured during sustained ventricular fibrillation clustered significantly below the SSP restitution curve, at significantly shorter APDs (57 +/- 4 ms) and DIs (49 +/- 6 ms) than could be achieved during SSP. In addition, abrupt increases in CL following SSP resulted in APDs significantly shorter than those predicted from the SSP restitution curve. Conclusion: Our results indicate that the responses of APD and DI to sudden rate changes and during arrhythmias are not predicted by the SSP restitution relationship. Acute dynamics act to damp out the proarrhythmic oscillations predicted from the SSP restitution curve.
引用
收藏
页码:455 / 463
页数:9
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