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F H Wittkampf

Publications and source records attributed to F H Wittkampf.

9 recordsLinked to original sources

Electrocardiogram of the humpback whale (Megaptera novaeangliae), with specific reference to atrioventricular transmission and ventricular excitation.

OBJECTIVES: The objective of the study was to record the electrocardiogram (ECG) of a large whale to obtain crucial data for comparative electrophysiologic analysis. BACKGROUND: The data were needed to establish the mismatch between heart size and PR interval and QRS duration in mammals. METHODS: In the waters off the coast of Newfoundland, in two humpback whales (Megaptera novaeangliae) with an estimated weight of 30,000 kg a 1-lead ECG was recorded, enabling reliable assessment of P waves and QRS complexes. RESULTS: It was found that both the PR interval (atrioventricular [AV] transmission time) and QRS duration (ventricular excitation) are extremely short for animals of this size. These findings are difficult, if not impossible, to explain on the basis of currently accepted electrophysiologic theories. However, the narrow QRS complex may be due to a very dense His-Purkinje network in the ventricular wall of whales. Alternative mechanisms that can explain the function of the mammalian AV node need to be considered and explored. CONCLUSIONS: The results of the study may be of value for the understanding of the ECG in humans.

Animals

Control of radiofrequency lesion size by power regulation.

The influence of power and exposure duration on lesion size in radiofrequency catheter ablation was investigated in 15 closed-chest dogs. Radiofrequency energy was delivered to the right ventricular endocardium between the tip of a standard 6F electrode catheter and a large W and durations of 5, 10, 20, 30, and 60 seconds. At necropsy 1 week later, well-demarcated homogeneous lesions were found when power had exceeded a threshold level that decreased from 1.8 W at 5 seconds to 0.7 W at 60 seconds. Lesion size ranged from 0 to 7.5 mm in depth and 0 to 9 mm in diameter. For the 5, 10, and 20 second ablations, lesion size was determined by exposure duration and power level. However, after a 20 second exposure, lesion size had reached maturity and was related to delivered power only. Therefore, a gradual, controlled growth of the lesion can be obtained by a stepwise increase of the radiofrequency power level with ample exposure duration at each level to allow for stabilization. At levels exceeding 7 W, the formation of a thin insulating layer of blood coagulum on the electrode surface caused an abrupt increase of impedance within approximately 30 seconds. Therefore, lesion size is limited to 8.5 mm in radiofrequency ablation with a standard 6F endocardial electrode catheter.

Animals

Effect of right ventricular pacing on ventricular rhythm during atrial fibrillation.

In 13 patients with atrial fibrillation, the effect of right ventricular pacing at various rates on spontaneous RR intervals was studied. Five hundred consecutive RR intervals were recorded and measured before and during varying right ventricular pacing rates. As anticipated, all RR intervals longer than the right ventricular pacing intervals were abolished. However, RR intervals shorter than the right ventricular pacing intervals were also eliminated. It is difficult to explain the elimination of RR intervals shorter than the pacing intervals with the accepted concepts concerning the mechanisms governing the rate and rhythm of the ventricular response to atrial fibrillation. An alternative explanation may be that during atrial fibrillation the atrioventricular node behaves as a nonprotected pacemaker that is electrotonically modulated by the chaotic atrial electrical activity. The result is a random ventricular rhythm. With right ventricular pacing, the automatic focus is depolarized by the retrogradely concealed conducted ventricular impulses, the short RR intervals are not generated as a consequence and the rhythm becomes pacemaker dependent.

Aged

Morphology of endocardial T-waves of fusion beats.

Recently developed stimulation techniques are capable of eliminating polarization afterpotentials caused by the emitted stimulus. A well-controlled study method was developed to initiate various degrees of fusion and to monitor changes in the morphology of the endocardial signal. The study was performed on two dogs. The zone during which fusion could be provoked was less than 30 ms in both dogs. In addition, the results show a significant decrease in the endocardial T-wave amplitude as soon as fusion was noticed, while the QT interval then slightly lengthened. Furthermore, the evoked R-wave duration shortened during fusion, while the stimulus to R-wave interval lengthened. These results have consequences for pacemakers that use evoked endocardial signal characteristics for driving a pacemaker function.

Animals

Reliability of evoked endocardial T-wave sensing in 1,500 pacemaker patients.

Intracardiac measurements of the evoked endocardial T-wave were performed on 1,500 pacemaker patients. The sensed evoked T-wave amplitude was found to be above 0.75 mV in 94.1 percent of all cases. No correlation was found between the amplitude of the spontaneous R-wave and that of the evoked T-wave. Some electrode characteristics proved to be more favorable than others for evoked endocardial wave sensing, i.e., a surface area of less than 12 mm2, porous surface structure (preferably carbon), and atraumatic fixation.

Electrocardiography

Rate stabilization by right ventricular pacing in patients with atrial fibrillation.

A recent study of de Jongste has demonstrated the lengthening of short R-R intervals in patients with atrial fibrillation by right ventricular pacing. We have further analyzed the data from this study and specifically looked at the effect of right ventricular pacing on the R-R interval instability and heart rate. At the cost of only a slight increase in mean heart rate, a major reduction of the R-R interval instability can be obtained by right ventricular pacing. Based on these findings, we have developed and evaluated an automatic pacing rate algorithm, which continuously varies the stimulation rate in order to stabilize the otherwise irregular rhythm in patients with atrial fibrillation.

Atrial Fibrillation