Biomedical subjects

V López-Merino

Publications and source records attributed to V López-Merino.

At least 19 recordsLinked to original sources

PubMed1999

Low-dose dobutamine testing using contrast left ventriculography in the same session as coronary angiography predicts the improvement of left ventricular function after coronary angioplasty in postinfarction patients.

The role of percutaneous transluminal coronary angioplasty (PTCA) in the subacute or chronic phases of myocardial infarction remains controversial. This study investigates the usefulness of dobutamine contrast left ventriculography in a single session with coronary angiography for predicting the improvement of ventricular function after PTCA. The study group consisted of 30 patients in whom a contrast left ventricular angiogram and PTCA were performed after a first myocardial infarction. The centerline method was used to calculate dysfunction extent at baseline and its variation during dobutamine infusion at 7.5 microg/kg/min; contractile reserve was defined as a significant (> or = 15%) reduction of dysfunction extent. A second ventricular angiogram was performed 6 months later in all patients. Abnormal wall motion extent decreased at 6 months after PTCA (84+/-21% vs 70+/-29%, p = 0.0001). Wall motion improvement after PTCA correlated with the response to dobutamine (r = 0.54, p = 0.002). Ten patients showed a significant reduction (> or = 15%) of dysfunction extent at 6 months; dobutamine testing had a 80% sensitivity, 84% specificity, 67% positive predictive value, and 89% negative predictive value in detecting regional function improvement. In the subgroup of 21 patients without restenosis, both the correlation between dysfunction improvement after PTCA and response to dobutamine (r = 0.72, p = 0.0001) and the accuracy of dobutamine testing (sensitivity 88%, specificity 92%, positive predictive value 88%, and negative predictive value 92%) increased. The ejection fraction significantly increased (>5%) after PTCA in 6 patients; dobutamine testing had a 67% sensitivity, 74% specificity, 44% positive predictive value, and 88% negative predictive value in predicting the increase in the ejection fraction. In the subgroup without restenosis the improvement of the ejection fraction correlated with the response to dobutamine (r = 0.63, p = 0.007), and the sensitivity of dobutamine testing was 80%, specificity 83%, positive predictive value 67%, and negative predictive value 91%. In conclusion, dobutamine contrast left ventriculography testing in the same session as coronary angiography predicts regional function and ejection fraction improvement after PTCA in postinfarction patients, particularly when restenosis does not develop.

Aged↗

PubMed1998

[Acute changes in wavelength of the process of auricular activation induced by stretching. Experimental study].

OBJECTIVE: An evaluation is made of the acute modifications in the wavelength of the atrial excitation process induced by atrial stretching. MATERIAL AND METHODS: In 10 isolated Langendorff-perfused rabbit hearts and using a multiple electrode the wavelength of the atrial activation process (functional refractory period x conduction velocity) was determined in the right atrium. An analysis was also made of the inducibility of rapid repetitive atrial responses after 20 episodes of atrial burst pacing. Measurements were made under control conditions, after inducing two degrees of atrial wall stretch (D1 and D2), and following the suppression of atrial dilatation. RESULTS: Under control conditions the wavelength was 72.6 +/- 7.7 mm (250 ms cycle) and 54.0 +/- 5.1 mm (100 ms cycle). In D1 (mean longitudinal increase in atrial wall length = 24 +/- 3%) the wavelength shortened, with values of 59.8 +/- 6.6 mm (250 ms cycle; p < 0.01) and 44.9 +/- 5.1 mm (100 ms cycle; p < 0.01). In D2 (mean longitudinal increase in atrial wall length = 41 +/- 4%) the wavelength also shortened significantly, with values of 41.6 +/- 2.5 mm (250 ms cycle; p < 0.01 vs control) and 29.6 +/- 2.1 mm (100 ms cycle; p < 0.01 vs control). After suppressing atrial dilatation the wavelength was 65.7 +/- 8.0 mm (250 ms cycle, NS vs control) and 47.9 +/- 5.5 mm (100 ms cycle; NS vs control). The inducibility of rapid repetitive atrial responses increased during dilatation (22 episodes with over 30 consecutive repetitive responses in D1 [p < 0.01], 50 episodes in D2 [p < 0.001] vs 5 episodes under control conditions), and diminished after suppressing atrial dilatation (0 episodes with over 30 consecutive repetitive responses; p < 0.05). CONCLUSIONS: In the experimental model used, acute atrial dilatation produced a shortening in refractoriness and a decrease in conduction velocity. Both effects shortened the wavelength of the atrial activation process, facilitating the induction of atrial arrhythmias. The effects observed reverted upon suppressing atrial dilatation.

Animals↗

PubMed1998

Acute effects of radiofrequency ablation upon atrial conduction in proximity to the lesion site.

The electrophysiological effects of RF ablation upon the areas in proximity to the lesioned zones have not yet been well characterized. An experimental model is used to investigate atrial conduction in the boundaries of RF damaged zones. In 11 isolated and perfused rabbit hearts, endocardial atrial electrograms were recorded using an 80-lead multiple electrode positioned in the left atrium. Both before and after the RF application (5 W, 8 s, 1-mm diameter unipolar epicardial electrode) in the mid-portion of the free left atrial wall, measurements were made of conduction time from the pacing zone (posterior wall of the left atrium) to three points between 7.5 and 7.9 mm distal to the damaged zone. Conduction velocity and the direction of the activation propagation vector were determined in ten groups of four electrodes positioned around the damaged zone, and at the left atrial appendage. The mean diameter (+/- SEM) of the transmural lesions produced by RF ablation and defined by macroscopic examination was 4.2 +/- 0.2 mm. The conduction times to the three points distal to the lesion site were significantly prolonged as a result of RF ablation; 7.6 +/- 0.4, 7.4 +/- 0.5, and 6.9 +/- 1.0 ms (control); and 11.3 +/- 1.0 (P < or = 0.01), 11.1 +/- 1.3 (P < 0.01), 10.6 +/- 1.4 ms (P < 0.05) (post-RF). The differences between the conduction velocities determined in the areas surrounding the lesion, before and after RF application, failed to reach statistical significance: 86.2 +/- 6.5 cm/s (control) versus 75.5 +/- 5.7 cm/s (post-RF) (NS). After RF, significant variations were only observed in the direction of impulse propagation in the proximal-inferior quadrant adjacent to the lesion site, the difference being -61 degrees +/- 18 degrees (P < 0.02). In 2 of 4 experiments in which the lesion size was increased by a second RF application (5 W, 16 s), tachycardias with activation sequence around the lesion could be induced, with cycle lengths of 56 and 50 ms, respectively. In the atrial wall, the conduction times to the regions distal to the RF lesion are significantly prolonged. No significant changes are observed in conduction velocity in the areas in proximity to the lesion. Prolonged conduction to the areas distal to the ablation site is due to the lengthened pathway traveled by the impulses in reaching these areas. Tachycardias with activation patterns that suggest reentry around the RF damaged zone may be induced.

Animals↗

PubMed1998

Quantification of the modifications in the dominant frequency of ventricular fibrillation under conditions of ischemia and reperfusion: an experimental study.

The characteristics of ventricular fibrillatory signals vary as a function of the time elapsed from the onset of arrhythmia and the maneuvers used to maintain coronary perfusion. The dominant frequency (FrD) of the power spectrum of ventricular fibrillation (VF) is known to decrease after interrupting coronary perfusion, though the corresponding recovery process upon reestablishing coronary flow has not been quantified to date. With the aim of investigating the recovery of the FrD during reperfusion after a brief ischemic period, 11 isolated and perfused rabbit heart preparations were used to analyze the signals obtained with three unipolar epicardial electrodes (E1-E3) and a bipolar electrode immersed in the thermostatized organ bath (E4), following the electrical induction of VF. Recordings were made under conditions of maintained coronary perfusion (5 min), upon interrupting perfusion (15 min), and after reperfusion (5 min). FrD was determined using Welch's method. The variations in FrD were quantified during both ischemia and reperfusion, based on an exponential model deltaFrD = A exp (-t/C). During ischemia deltaFrD is the difference between FrD and the minimum value, while t is the time elapsed from the interruption of coronary perfusion. During reperfusion deltaFrD is the difference between the maximum value and FrD, while t is the time elapsed from the restoration of perfusion. A is one of the constants of the model, and C is the time constant. FrD exhibited respective initial values of 16.20 +/- 1.67, 16.03 +/- 1.38, and 16.03 +/- 1.80 Hz in the epicardial leads, and 15.09 +/- 1.07 Hz in the bipolar lead within the bath. No significant variations were observed during maintained coronary perfusion. The fit of the FrD variations to the model during ischemia and reperfusion proved significant in nine experiments. The mean time constants C obtained on fitting to the model during ischemia were as follows: E1 = 294.4 +/- 75.6, E2 = 225.7 +/- 48.5, E3 = 327.4 +/- 79.7, and E4 = 298.7 +/- 43.9 seconds. The mean values of C obtained during reperfusion, and the significance of the differences with respect to the ischemic period were: E1 = 57.5 +/- 8.4 (P < 0.01), E2 = 64.5 +/- 11.2 (P < 0.01), E3 = 80.7 +/- 13.3 (P < 0.01), and E4 = 74.9 +/- 13.6 (P < 0.0001). The time course variations of the FrD of the VF power spectrum fit an exponential model during ischemia and reperfusion. The time constants of the model during reperfusion after a brief ischemic period are significantly shorter than those obtained during ischemia.

Animals↗

PubMed1997

Are double potentials markers of a specific zone of the atrioventricular junction in the isolated rabbit heart?

A study is made of the characteristics of the atrial potentials recorded in the Koch triangle and its proximity, their variations on modifying the site of cardiac pacing, and their usefulness as markers of a distinct zone of the AV junction. In 12 isolated and perfused rabbit heart preparations an analysis was made of the endocardial atrial electrograms recorded with a multiple electrode positioned in the AV junction. The electrograms were obtained during spontaneous rhythm and on pacing at the crista terminalis (CT), interatrial septum (IAS), left atrium, and right ventricle. Double potentials were frequently obtained. On pacing at the CT, high-low double potentials (DP [H-L]) were more frequent (P < 0.05) in the low CT (11% +/- 4% of the electrodes) and posterior zone of the Koch triangle (6% +/- 5%), than in the IAS (1% +/- 2%) and anterior zone of the Koch triangle (2% +/- 3%). A similar tendency was observed either on pacing at the left atrium or during spontaneous rhythm. During pacing at the IAS the percentages of low-high double potentials (DP (L-H]) were significantly higher (P < 0.05) in the low CT (7% +/- 6%). DP (H-L) were of low sensitivity in indicating a given zone; maximum sensitivity was 61% in the low CT when pacing at the CT. DP (L-H) proved even less sensitive in indicating a given zone, though their specificity was greater in the low CT (91%) during pacing at the IAS. The specific zones in which the highest percentages of DP (H-L) or DP (L-H) are obtained depend on the site of cardiac pacing. On pacing at the IAS, DP (L-H) are more specific of the low CT. During pacing at both the CT and at the IAS, DP (H-L) sensitivity in indicating a given zone is low.

Action Potentials↗

PubMed1997

Modification of atrioventricular nodal electrophysiology by selective radiofrequency delivery on the anterior or posterior approaches.

An analysis was made in 14 isolated and perfused rabbit hearts of the electrophysiological effects of selective radiofrequency (RF) delivery in the anterior (group I, n = 7) or posterior zone (group II, n = 7) of the Koch triangle, with the aim of modifying atrioventricular nodal (AVN) conduction without suppressing 1:1 transmission. After opening the right atrium, RF was delivered (0.5 W) with a 1-mm diameter unipolar electrode positioned in the selected zone until a prolongation of no less than 15% was obtained in the Wenckebach cycle length (WCL). Before and after (30 min) RF, anterograde and retrograde AVN refractoriness and conduction were evaluated, stimulating from the crista terminalis (CT), the interatrial septum (IAS), and from the RV epicardium. After RF, the following percentage increments were observed in group I: AH(CT) = 36% +/- 9%, AH(IAS) = 38% +/- 11%, WCL(CT) = 28% +/- 8%, WCL(IAS) = 22% +/- 6%, functional refractory period (FRP) of the AVN(CT) = 13% +/- 11%, FRP-AVN(IAS) = 13% +/- 8%, retrograde WCL = 20% +/- 19%, and retrograde FRPVA = 13% +/- 16%. The increments observed in group II and the significances of the differences with respect to group I were: AH(CT) = 11% +/- 14% (P < 0.01), AH(IAS) = 19% +/- 32% (NS), WCL(CT) = 42% +/- 14% (P < 0.05), WCL(IAS) = 42% +/- 16% (P < 0.01), FRP-AVN(CT) = 28% +/- 28% (NS), FRP-AVN(LAS) = 21% +/- 19% (NS), retrograde WCL = 35% +/- 24% (NS), and retrograde FRP = 16% +/- 13% (NS). In both groups, the AH interval variations were not correlated with those of the rest of the parameters analyzed. Truncated nodal function curves suggestive of a dual AV nodal pathway were obtained in three experiments, though in only one of them was this observed under basal conditions. In the other two experiments, with dual AV nodal physiology only after RF (one from each group), AV nodal reentrant tachycardias were triggered with atrial extrastimulus at coupling intervals equal to or shorter than at those that cause a sudden lengthening of the AH interval, RF delivered in the anterior and posterior zones of the Koch triangle produced effects of different magnitude on the AH interval and Wenckebach cycle length. In the anterior zone the AH interval was prolonged to a greater extent, while in the posterior zone the effects were greater on the Wenckebach cycle length. No correlation existed between the variations in AH interval and Wenckebach cycle length, regardless of where RF was delivered. The evaluation of anterograde AV nodal refractoriness was similar when stimulating from the crista terminalis or from the interatrial septum. By delivering RF, it was possible to induce dual AV nodal physiology and reentrant tachycardias.

Animals↗

PubMed1996

Modifications in the evolution of the dominant frequency in ventricular fibrillation induced by amiodarone, diltiazem, and flecainide. An experimental study.

In 22 anesthetized mongrel dogs, spectral methods were used to analyze the surface electrocardiogram (ECG) for the time course of the dominant frequency in ventricular fibrillation and its modifications under the influence of amiodarone, diltiazem, and flecainide. The ECG was recorded over 5 minutes after triggering ventricular fibrillation. Following A/D conversion and by applying the Fourier fast transform, the frequency spectrum of the signals was obtained. In group 1 (5 dogs), the ECGs were obtained without prior drug administration; group 2 (5 dogs) first received amiodarone, 5 mg/kg; group 3 (7 dogs) received diltiazem, 0.2 mg/kg; and group 4 (5 dogs) received flecainide, 2 mg/kg. All drugs were administered intravenously. An initial increase in the dominant frequency of ventricular fibrillation was found in the control group and also in the groups that received amiodarone, diltiazem, or flecainide. Diltiazem significantly increased the dominant frequency and diminished the arrhythmia-slowing process. Amiodarone and flecainide tended to diminish the dominant frequency.

Amiodarone↗

PubMed1995

Continuous heart rate variability monitoring through complex demodulation implemented with the fast Fourier transform and its inverse.

UNLABELLED: A new method for the analysis of 24-hour heart rate variability (HRV) using complex demodulation (CDM) implemented with the fast Fourier transform (FFT) and its inverse is described. In a control group with palpitations and dizzy spells (n = 30, 47.2 +/- 16.7 years) the relationship between HRV parameters and subject age was investigated. CDM was used to obtain the amplitude and frequency of the low frequency (LF) and high frequency (HF) oscillations for 8 diurnal hours and 4 nocturnal hours. Differences between the two periods were seen in the LF/HF ratio (2.2 +/- 0.6 vs 1.5 +/- 0.6; P < 0.0001), HF amplitudes (12 +/- 6 vs 17 +/- 7 normalized units, P < 0.05), and in the mean frequency of the LF oscillations (0.078 +/- 0.008 vs 0.073 +/- 0.007 Hz, P < 0.01). During the daytime, age was inversely correlated to HF amplitude (r = -0.60), directly correlated to HF mean central frequency (r = 0.40), inversely correlated to LF amplitude (r = -0.55), and likewise inversely correlated to LF mean central frequency (r = -0.74, P < 0.001). At night, age was only inversely correlated to HF amplitude and to LF mean central frequency. CONCLUSIONS: Continuous HRV monitoring through CDM implemented with the FFT and its inverse differentiates the periods of diurnal activity and nocturnal rest as an expression of two different activity states of the autonomic nervous system. It allows nonstationary analysis, and separately provides mean and instantaneous oscillation amplitude and frequency. Subject age is not equally related to mean amplitude and frequency of a given oscillation.

Adolescent↗

PubMed1994

The influence of different electrode configurations on the inhibitory effect of subthreshold high-frequency stimuli.

Subthreshold stimuli trains may inhibit the response to a subsequent suprathreshold stimulus; the inhibitory effect decreases or even disappears when the subthreshold stimuli are delivered apart from the suprathreshold stimulus. The purpose of this study is to analyse, in atrial epicardium, the influence of different electrode configurations upon the inhibitory effect of subthreshold stimuli trains delivered at a short distance from the explored zone. In 18 anaesthetized dogs, the basal atrial effective refractory period was determined using an epicardial unipolar cathodal electrode. A second determination was performed when a subthreshold stimuli train (1 ms cathodal pulses, 800 Hz, and intensity 10% less than the diastolic threshold of the train) was delivered prior to the extrastimulus through: (a) 8 electrodes equidistant (4.5 mm) from the central test electrode (Group 1, n = 5); (b) a 1 mm wide ring electrode, 2.5 mm from the central test electrode (Group 2, n = 7); and (c) a 3.5 mm wide ring electrode, 2.5 mm from the central test electrode (Group 3, n = 6). A third determination was performed in all experiments delivering both the subthreshold stimuli train and the extrastimulus through the same central test electrode. Atrial effective refractory period did not vary significantly with respect to the basal values in Group 1 (141 +/- 22 vs 142 +/- 25 ms; ns) though it increased in Group 2 (168 +/- 27 vs 142 +/- 18 ms; P < 0.01) and in Group 3 (160 +/- 20 vs 133 +/- 25 ms; P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

[The spectral analysis of heart rate variability. The methodological aspects].

OBJECTIVES: A study is made of the influence of methodology on the analysis of cardiac cycle variability in terms of frequency and time domains. METHODS: Twenty-five individuals were divided into three groups: 1) non-smokers (n = 10); 2) smokers (n = 8); and 3) non-smokers without guided respiratory frequency (n = 7). An analysis was made of RR variability during 5 min intervals in time domain (standard deviation, variation coefficient, and difference between maximum and minimum RR), and frequency domain (spectral analysis, Fast Fourier Transform algorithm using 5 types of data windows). RESULTS: On comparing the results obtained in the 25 individuals with the 5 data windows, significant differences were observed (ANOVA; p < 0.001) in maximum and total amplitudes of the spectrum (in absolute terms) in the low frequency band (0.04-0.15 Hz). No significant differences were found between the normalized values or between the low/high (0.15-0.40 Hz) frequency ratio: W1 = 1.63 +/- 0.30; W2 = 1.62 +/- 0.29; W3 = 1.65 +/- 0.31; W4 = 1.52 +/- 0.26, and W5 = 1.55 +/- 0.27 (X +/- SE). On averaging the RR intervals each 5 cycles, significant differences were encountered for great part of the parameters studied. No significant differences were encountered for great part of the parameters studied. No significant differences were noted between the non-smokers as regards the use or non-use of a metronome (low/high frequency ratio in group 1 = 1.85 +/- 0.39 vs group 3 = 1.78 +/- 0.43; NS). The linear regressions between the variability parameters in terms of time and frequency domains (absolute values), and age (group 1) were significant, with greater regression coefficients on using the linear transformation of an exponential model. On comparing groups 1 and 2, a non statistically significant trend towards smaller maximum and total amplitudes (absolute values) was noted in group 2 for both frequency bands. CONCLUSIONS: 1) The type of data window (Fourier analysis) introduces significant modifications of some parameters expressed in absolute values, but not between normalized values; 2) signal averaging greatly modifies the information obtained; 3) the decrease in variability parameters observed with age fits better to an exponential model; 4) no differences were detected on guiding or not respiratory frequency, and 5) smoking appears to induce a tendency towards reducing cardiac cycle variability.

Adult↗

PubMed1993

Radiofrequency versus pharmacologic modification of the atrioventricular node.

Although transcatheter radiofrequency modification of the atrioventricular (AV) node has been proposed as curative treatment in AV nodal reentry tachycardias, its role for the control of the ventricular rate in atrial tachyarrhythmias remains unclear. The aim of this study was to analyze the acute effect of radiofrequency current on AV nodal conduction and refractoriness, and to compare it with the effects of two antiarrhythmic drugs such as amiodarone (class III) and flecainide (class I). Twenty-one dogs were studied: (1) radiofrequency group (5 W for less than 45 seconds; 2 to 12 discharges; seven dogs); (2) amiodarone group (5 mg/kg intravenously; seven dogs); and (3) flecainide group (2 mg/kg intravenously; seven dogs). The following parameters were measured under basal conditions and after each procedure: AH interval, AV nodal functional refractory period, Wenckebach cycle length, minimum R-R interval during atrial fibrillation, and fitting of AV nodal function curve to a hyperbolic equation using its linear transformation. The AV nodal effective refractory period could not be calculated in any dog in the basal study because it was shorter than the atrial functional refractory period.(ABSTRACT TRUNCATED AT 250 WORDS)

Amiodarone↗

PubMed1992

The effects of selective stellate ganglion manipulation on ventricular refractoriness and excitability.

The effects of selective stellate ganglion stimulation or stellectomy on ventricular excitability were studied in 30 open chest mongrel dogs anesthetized with alpha-chloralose. The effective refractory period (ERP) and strength interval curves (stimulus intensity [S2] = twice the diastolic threshold [ERP], and 2, 3, 5, 7, and 14 mA) were determined using bipolar epicardial electrodes placed in the mid-anterior wall of the right ventricle (RV) and the mid-posterolateral wall of the left ventricle (LV) during left stellate ganglion stimulation (LSGSt, n = 8) or right stellate ganglion stimulation (RSGSt, n = 8), or after left stellectomy (LSGEx, n = 7) or right stellectomy (RSGEx, n = 7). LSGEx prolonged ERP-LV (172 +/- 9 vs 167 +/- 8 msec, P < 0.05) and ERP-RV (163 +/- 10 vs 158 +/- 14 msec, P < 0.05). RSGEx prolonged ERP-LV (168 +/- 17 vs 162 +/- 15 msec, P < 0.01) and ERP-RV (166 +/- 14 vs 160 +/- 13 msec, P < 0.01), and the times of the strength interval curves obtained for each S2 intensity in both ventricles. LSGSt decreased ERP-LV (157 +/- 11 vs 163 +/- 12 msec, P < 0.01) and ERP-RV (147 +/- 18 vs 157 +/- 17 msec, P < 0.05), and the times of the strength interval curves obtained for each S2 intensity in both ventricles. RSGSt did not significantly decreased ERP-LV (152 +/- 11 vs 156 +/- 9 msec); however, it significantly shortened the times of the strength interval curves obtained for S2 intensities of 2 and 7 mA in the LV, and shortened ERP-RV (139 +/- 10 vs 145 +/- 7 msec, P < 0.01) and the times of the strength interval curve for S2 intensities of 2, 3, and 5 mA in the RV. A significant interaction (MANOVA test) was observed between the ventricle studied and the ganglion stimulated for S2 intensities of 2 and 3 mA, and between the effect of stimulation and the ganglion stimulated for S2 intensities of 3 and 14 mA. To conclude, selective stellectomy prolonged epicardial ventricular refractoriness in both the mid-anterior wall of the RV and the mid-posterolateral wall of the LV; the magnitude of the epicardial excitability variations in both areas was different during selective stellate ganglion stimulation.

Analysis of Variance↗

PubMed1991

Atrioventricular electrotonic interaction in complete atrioventricular block: an experimental model using radiofrequency energy in the rabbit heart.

UNLABELLED: Provided the conditions for electrotonic transmission exist, an automatic focus surrounded by a block zone may be externally modulated. The atrioventricular (AV) electrotonic interaction was studied in 16 perfused rabbit hearts with supra-Hisian complete AV block induced using low radiofrequency energy doses (2.5 watts; 10 seconds). In nine experiments the sinus node was preserved (group I), whereas in seven it was removed maintaining an AV nodal rhythm (group II). The V-V (ventricular cycle length) and V-A (coupling of the intervening atrial beat) in both groups, and also the A-A (atrial cycle length) and A-V (coupling of the intervening ventricular beat) intervals in group II, were measured beat by beat after current delivery. The phase response curves V-V versus V-A, and A-A versus A-V showed AV interaction in five experiments from group I, and in four from group II, as follows: (1) accelerating phase response curve, characterized by a pacemaker acceleration (V-V or A-A abbreviation) at a critical V-A or A-V coupling interval; maximum acceleration could be progressively (phase response curve without rapid cross-over) or briskly (phase response curve with rapid crossover) reached; from this point onwards acceleration decreased with a further increase in V-A or A-V coupling interval (acceleration slope). (2) Biphasic phase response curve, characterized by initial delaying and late accelerating phases. Maximum acceleration and the acceleration slope were both smaller in accelerating phase response curves without rapid cross-over. On reverting complete block in two experiments, a progressive increase in maximum acceleration and acceleration slope was observed. CONCLUSIONS: (1) AV interaction in complete AV block can be manifested as accelerating or biphasic phase response curves; (2) transition from electrotonic interaction to conduction seems to be a continuum.

Animals↗

PubMed1990

Transcatheter ablation of the sinus node in dogs using high-frequency current.

Sinus node ablation by high-frequency current (HFC) (0.7 MHz. 5-10 W), delivered through the distal electrode of a conventional endocavitary catheter, was induced in seven thoracotomized dogs under autonomic blockade. The HFC was delivered for variable periods of time under ECG monitoring, while sinus tachycardia was produced or after attaining sinus arrest. The procedure was repeated until a stable non-sinus rhythm was obtained. Sinus rhythm was abolished in all seven dogs after a variable number (7-20) of discharges. The escape rhythm obtained after the last discharge, characterized by means of epicardial electrodes and analysis of P-wave morphology, length of PR interval and the rate, showed an atrial activation pattern different from sinus rhythm in all cases. The P-wave was retrograde in two cases, and in one case no atrial activity was detected after the last discharge; however, atrial activity recovered after 35 min, the activation pattern being different from the controls. After 2 h, sinus rhythm had not returned in any case. In no case was there perforation of the atrial wall. Acute histological findings showed coagulation necrosis of the endocardium, extending to the muscle fibres and affecting the sinus cells.

Animals↗

PubMed1990

Closed chest radiofrequency ablation of the sinoatrial node in dogs.

UNLABELLED: Transcatheter ablation of the sinoatrial node with radiofrequency energy (0.6 MHZ, 2.5-5 watts) was performed in 10 dogs under fluoroscopic monitoring and autonomic blockade. Sinus function was previously studied in terms of cycle length, recovery time and atrial activation pattern by catheter mapping. Several discharges (8-22) were applied for variable periods of time (maximum 1 minute). Sinus tachycardia and/or sinus arrest during ablation confirmed correct catheter position. Sinus rhythm was abolished in eight dogs. The ectopic rhythm was atrial in six and AV nodal in two dogs. Ectopic atrial cycle length and recovery time were longer than the baseline sinus values: 724 +/- 321 versus 509 +/- 147, P less than 0.05; 1103 +/- 775 versus 618 +/- 151, P less than 0.05 (values in msec). The study was repeated 10-14 days later in six dogs; three maintained the same atrial rhythm, one persisted in sinus rhythm, and one dog changed from atrial to sinus rhythm, whereas another changed from sinus to atrial rhythm. Gross findings revealed transmural lesions in all dogs, without perforation. Histology in chronic dogs showed sinus cell necrosis and its replacement by granulation tissue. IN CONCLUSION: sinus function may be abolished by closed chest radiofrequency ablation.

Animals↗

PubMed1989

[Heart rate-ventricular extrasystole relations and their dependence on circadian rhythms].

The linear correlation of the circadian rhythms (CR) of heart rate (HR) with those of ventricular extrasystole (VE) is analyzed by electrocardiographic ambulatory monitoring in 32 patients: 22 with ischemic post-infarction cardiopathy (group A) and ten free of structural cardiopathy (group B). Variability expressed as the coefficient of ventricular extrasystole variation (100 x standard deviation/mean) presented an inverse correlation with the number of recording extrasystoles. Linear correlation between HR and VE was statistically significant in 72% of recordings in group A, and in 60% in group B. The percentage of cases with significant linear correlation was greater on analyzing the three-minute periods than with the longer periods. When the cases analyzed presented over 200 extrasystoles, the percentage with significant linear correlation between HR and extrasystole was greater in group A than in group B. The circadian rhythm of the ventricular extrasystoles using interpolation of a cosinor function was significant in 50% of group A cases, and in 60% of group B. The achrophases were diurnal in group B, but only in 45% of cases in group A, two correspondence models being found between the CR achrophases and the inverse linear correlation between HR and VE.

Adolescent↗

PubMed1989

[Experimental study of the effects of ATP on sinus automatism and atrioventricular node conduction].

A study was made of 14 thoracotomized dogs under i.v. sodium thiopental anesthesia; the effects of 1.5 mg/kg intravenous ATP on sinus node automatism and atrio-ventricular conduction were investigated. In 7 dogs (group A) ATP was administered under control conditions and following successive intravenous administrations of atropine (1 mg/kg), aminophylline (5 mg/kg) and propranolol (0.6 mg/kg). The remaining 7 dogs (group B) received ATP following atropine (1 mg/kg), isoproterenol (0.4 microgram/kg/min.), and aminophylline (5 mg/kg). An analysis was made of the percentage variations in cardiac cycle length during spontaneous rhythm and of the AH interval during atrial pacing at a fixed rate. In group A the negative dromotropic and chronotropic effects of ATP under control conditions decreased in 5 cases following atropine, although the average decrease was not statistically significant. On adding aminophylline, a statistically significant decrease was observed in the effects of ATP, and following propranolol the drop in negative chronotropic effect of ATP provoked by aminophylline was maintained. In group B, and following prior atropinization, the negative chronotropic and dromotropic effects of ATP were maintained in the presence of isoproterenol. As in group A, aminophylline significantly reduced the effects of ATP. To conclude: in the thoracotomized dog under sodium thiopental anesthesia, 1) atropine does not prevent the negative chronotropic and dromotropic actions of ATP, although the effect of the latter is decreased in a large percentage of cases; 2) sympathetic beta stimulation following prior atropinization does not prevent ATP action; 3) aminophylline in the atropinized dog noticeably reduces the effects of ATP, and 4) this action of aminophylline is effective in the presence of sympathetic beta stimulation.

Adenosine Triphosphate↗

PubMed1989

[Prediction of the tachycardia cycle based on auriculoventricular re-entry. Experimental study in dogs].

Seven anaesthesized mongrel dogs subject to thoracotomy were used in a electronic simile of A-V accessory pathway with retrograde conduction to generate reentrant tachycardias with different ventriculo-atrial delays. This was done both under control conditions and following amiodarone i.v. administration. The ability to predict tachycardia cycle length was studied, using a mathematical model of the circuit, in which the cycle length is obtained from the function of nodal conduction and the time of extranodal conduction of the circuit. An analysis was made of the repercussions in using four different mathematical functions describing nodal conduction: three were non-linear (exponential and hyperbolic A and B) and one linear. In the case of the first three, the consequences of using a direct non-linear data-fitting procedure or an indirect procedure by linear transformations of the functions were studied. The exponential and hyperbolic B functions provide a better prediction of tachycardia cycle length on being used in the model; in the case of these functions, a mean value of the squared differences between the real and estimated values of 19.1 +/- 31.0 ms2 and 19.1 +/- 26.7 ms2, respectively, was obtained.

Animals↗