PubMed Health⌕ Search

Biomedical subjects

H Kasanuki

Publications and source records attributed to H Kasanuki.

At least 19 recordsLinked to original sources
PubMed1992

Background current in sino-atrial node cells of the rabbit heart.

1. The Ca2+ current, K+ current, hyperpolarization-activated current, Na(+)-K+ pump current and the Na(+)-Ca2+ exchange current were all blocked by appropriate blockers and the remaining time-independent currents were investigated in single pacemaker cells of the rabbit sino-atrial node using the whole-cell patch clamp technique. 2. Exchanging the bathing solution from Tris-hydroxymethyl-aminomethane hydrochloride (Tris) Na+ free to 150 mM-Na+ induced an inward current and the slope conductance of the current-voltage relationship increased from 0.45 +/- 0.18 to 0.87 +/- 0.33 nS (n = 71) at -50 mV. The remaining conductance in Tris Na(+)-free solution was essentially the same when Tris was substituted with tetraethylammonium (TEA) or N-methyl-D-glucamine (NMG). The current density of the Na(+)-dependent inward current obtained by subtracting the current in Tris Na(+)-free from that in 150 mM-Na+ solution was 0.73 +/- 0.21 pA/pF (n = 71) at -50 mV. We called this current the Na(+)-dependent background current. 3. The membrane conductance was reduced by lowering the temperature of the external solution from 36 to 23 degrees C. In Tris Na(+)-free solution, the temperature-sensitive component was outward at all potentials, whereas it showed a reversal potential at around -20 mV in 150 mM-Na+ solution. This reversal potential was interpreted as a sum of the Cs+ efflux and Na+ influx, by comparing the Na(+)-dependent inward currents obtained at 36 degrees C and those at 23 degrees C. 4. Divalent cations (2 mM-Ni2+, 1 mM-Ba2+ or 2 mM-Ca2+) reduced only the outward current in the Tris Na(+)-free solution, while in the 150 mM-Na+ solution, they reduced both the inward and outward components of the current which had a reversal potential of around -10 mV. 5. Amiloride depressed the membrane conductance in 150 mM-Na+, Cs+ or Rb+ external solution, though only at negative membrane potentials, which suggests amiloride has a voltage-dependent effect on the background current. 6. Removal of Cl- from the external solution or the addition of a Cl- channel blocker (4,4'-dinitrostilbene-2,2'-disulphonic acid disodium salt, DNDS) failed to affect the membrane conductance. 7. When the monovalent cation-dependent inward current was measured by subtracting the current in the Tris solution from those recorded in the various monovalent cation solutions, the current amplitude decreased in the order: Rb+ greater than K+ greater than Cs+ greater than Na+ greater than Li+, which suggests a poor cation selectivity of this current system.(ABSTRACT TRUNCATED AT 400 WORDS)

Amiloride↗
PubMed1992

Evaluation of proarrhythmic effect of antiarrhythmic drugs on ventricular tachycardia associated with congestive heart failure.

The usefulness and limitations of antiarrhythmic drugs in ventricular tachycardias (VT) associated with congestive heart failure remain uncertain. The purpose of this study is to evaluate the proarrhythmic effects of antiarrhythmic drugs in patients with refractory VT associated with left ventricular dysfunction using electrophysiologic study (EPS). Twenty-four patients with left ventricular dysfunction, defined by left ventricular ejection fraction (LVEF) lower than 40% using left ventriculography, were studied. The average LVEF was 29.5%. As for underlying heart disease, 14 had old myocardial infarction, 8 cases had dilated cardiomyopathy and 2 had aortic regurgitation. As a control to this group, 23 cases with underlying heart disease and LVEF higher than 40%, and 27 cases with no obvious heart disease were studied. We considered a drug to have proarrhythmic effects if 1) it decreased by one the number of stimuli needed to induce VT, 2) induced non-sustained VT in the control study which changed to induced sustained VT, 3) the sustained VT or ventricular fibrillation was newly induced, or 4) the induced sustained VT which was stopped by pacing in the control study changed to induced VT which could not be terminated by pacing and required DC shock. Proarrhythmic effects were recognized in 17 of 24 cases with left ventricular dysfunction. Of the 67 drug trials, proarrythmic effects were seen in 26. Proarrhythmias were observed in 9 of 23 cases (39.1%) with organic heart disease associated with LVEF higher than 40%. In 12 of 69 drug trials (17.4%) proarrhythmias were observed. Of 27 cases with no obvious heart disease 10 cases (37%) had proarrhythmias. In 14 of 130 drug trials (10.8%), proarrhythmias were recognized.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Spatial distribution of late potentials assessed by signal-averaged body surface mapping.

In order to evaluate the spatial location of late potentials (LPs), we designed a new system for the body surface mapping of signal-averaged, filtered ECG using 45 thoracic unipolar leads (5 X 9 array). Signals from patients with old myocardial infarction (MI, N = 8), arrhythmogenic right ventricular dysplasia (N = 1) and dilated cardiomyopathy (N = 2) were amplified and passed through a digital bandpass filter (60-300Hz). Departure maps, LP isopotential maps, and LP30 area maps were generated and superimposed. The LP30 duration was determined as the section between the filtered QRS endpoints and points 30 msec before. Isopotential maps of the LPs showed distinct positive and negative regions. In 8 cases with MI, the extreme was related to the zones indicated by departure maps, and LP30 area maps also corresponded to the departure areas. Most importantly, the spatial distribution for the LP30 area map was different for each type of disease. In conclusion, body surface LP isopotential maps and LP30 area maps may provide useful information concerning the spatial distribution of LPs.

Arrhythmias, Cardiac↗
PubMed1990

Detection of the spatial distribution of late potentials by body surface mapping using forty-five unipolar, leads.

For evaluating the spatial location of late potentials (LPs), the authors designed a new system for the body surface mapping of signal-averaged, filtered ECGs using forty-five thoracic unipolar leads (5 x 9 array). The signals from patients with old myocardial infarction (MI, N = 7) and arrhythmogenic right ventricular dysplasia (ARVD, N = 1) were amplified and passed through a bandpass (100-300 Hz) filter. The departure maps, LP isopotential maps, and LP30 area maps were generated and superimposed. The LP30 duration was determined as the section between the filtered QRS endpoints and points thirty milliseconds (ms) before. Isopotential maps of the LPs showed distinct positive and negative regions. In 7 cases with MI, the extreme was related to the zones indicated by the departure maps, and the LP30 area maps also corresponded to the departure areas. In 1 case of ARVD, endocardial fragmented activity directly recorded at the right ventricle closely corresponded with the region on the LP30 area map. In conclusion, body surface LP isopotential maps and LP30 area maps may provide useful information concerning the spatial distribution of endocardial fragmentation.

Arrhythmias, Cardiac↗
PubMed1989

Differentiation and mechanisms of prevention and termination of verapamil-sensitive sustained ventricular tachycardia.

The purpose of this study was to differentiate by means of electrophysiologic study, a drug's ability to terminate or to prevent ventricular tachycardia (VT). Differences between the 2 effects were examined in patients with VT and the underlying mechanisms were studied in verapamil-responsive idiopathic sustained VT. The clinical significance of the distinction for chronic oral drug therapy is discussed. Thirty-five cases of inducible sustained VT were studied. A drug was considered "preventive" if it prevented VT induction and repetitive ventricular response, and "terminating" if it stopped induced VT within 15 complexes or could stop VT after its intravenous administration. Prevention and termination occurred together in 13 of 19 cases (68%) with disopyramide, in 10 of 19 cases (53%) with procainamide, in 8 of 12 cases (67%) with lidocaine, in 11 of 15 cases (73%) with mexiletine, and in 10 of 16 cases (63%) with verapamil. In the 16 in which verapamil terminated VT, VT rate immediately before termination slowed markedly from 167 +/- 33 to 134 +/- 28 beats/min. In the 6 cases without preventative effects, minimal and maximal premature intervals for VT induction increased significantly, from 291 +/- 70 to 335 +/- 85 ms and 323 +/- 68 to 423 +/- 109 ms, respectively, after verapamil administration. In 2 cases in which verapamil had a terminating effect, 5 mg of verapamil restored sinus rhythm but 10 mg caused premature beats resembling VT complexes. In another 2, 5 mg of verapamil lengthened the minimal premature interval; 10 mg increased both minimal and maximal premature intervals and lengthened the VT cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1989

Cryosurgical ablation of accessory atrioventricular pathways without cardiopulmonary bypass: an epicardial approach for Wolff-Parkinson-White syndrome.

An epicardial approach has been developed and applied to 31 Kent bundles (23 parietal, 1 right anteroseptal, and 7 posteroseptal bundles) in 28 patients with Wolff-Parkinson-White syndrome. Our technique consists of dissection of the atrioventricular fat pad of the Kent bundle site using an ultrasonic aspirator and subsequent cryosurgical ablation. For the left parietal and posteroseptal pathways, the apex of the heart has to be retracted upward, but this maneuver was well tolerated in all patients. Moreover, even through a narrow operative field, the ultrasonic aspirator permitted deliberate dissection on the beating heart without injury to major coronary vessels or the atrial wall. In 89% of the patients, operation was performed without the use of heart-lung bypass. All patients were free from preexcitation. With this technique, all Kent bundles except that adjacent to the atrioventricular node can be ablated on the beating heart, usually without heart-lung bypass.

Adolescent↗
PubMed1989

Mechanism and prediction of sudden cardiac death in arrhythmia patients using electrophysiological studies.

Thirty nine cases, in which sudden cardiac death (SCD) was suspected, were studied to evaluate the mechanism and the prediction of SCD in arrhythmia-patients using electrophysiological studies (EPS). The 39 cases (28 male and 11 female) were located by surveying 2098 patients who underwent EPS for the evaluation of arrhythmias. Age at time of EPS ranged from 4 to 86 years, average 50.5 years. Time from EPS to death was 2 to 163 months, average 27.9 months. Underlying heart disease was: dilated cardiomyopathy in 11, old myocardial infarction in 5, ischemic heart disease in 5, hypertensive heart disease in 5, valvular heart disease in 3, hypertrophic cardiomyopathy in 2, arrhythmogenic right ventricular dysplasia in 1, myocarditis in 1, sarcoidosis in 1, cor pulmonale in 1, and no obvious heart disease in 4. Fifteen had a permanent pacemaker implanted. SCD in cases without a permanent pacemaker (24 cases): 2 had chronic complete A-V block (one BH block, one HV block), 1 had advanced A-V block (HV block), 3 had bundle branch block with first degree HV block, 9 had ventricular tachycardia (VT), 3 had sick sinus syndrome (SSS), 3 had paroxysmal atrial flutter, 1 had WPW syndrome and paroxysmal atrial fibrillation, 1 had paroxysmal atrial tachycardia, and 3 had premature ventricular beats and first degree HV block. SCD in cases with permanent pacemaker (15 cases): 5 had SSS, and 10 had A-V block. In 3 of the 5 with SSS and 7 of the 10 with A-V block, VT was found before pacemaker implantation. In our study, brady and tachyarrhythmias coexisted in 25 cases (64%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Direct arrhythmia surgery in ventricular tachycardia: an experience with 18 consecutive patients].

18 patients with ventricular tachycardia (VT) underwent direct arrhythmia surgery between 1984 and 1988. There were 8 patients with ischemic VT, and 10 with nonischemic VT. Operative technique consisted of ablative procedures of the arrhythmogenic area determined by pre- and intraoperative mapping. Induced VT was usually unstable and transient during operation, so that instantaneous multi-point mapping was necessary in almost cases. For VT originated in the left ventricle or interventricular septum, the earliest excitation point determined by the epicardial mapping did not always predict the endocardial arrhythmogenic focus. Pre- and/or intraoperative endocardial mapping was important in this regard. Cryocoagulation (-150 degrees C, 120 sec) was mainly used as an ablative procedure; for ischemic VT, endocardial resection was added, and in nonischemic VT originated in the right ventricular outflow tract, transmural resection was combined with the cryoablation. In performing surgery for nonischemic VT, care must have been taken to make transmural cryocoagulation because the arrhythmogenic focus could exist intramurally. There were no operative deaths. In one patient with nonischemic VT, reoperation was required. After a mean follow-up of 17 month, all the patients are free from sustained VT.

Adolescent↗