Quantitative Analysis of Left Ventricular Endocardial Activation During Progressive Ventricular Fibrillation

Because congestive heart failure (CHF) promotes ventricular fibrillation (VF), we compared VF in seven dogs with CHF induced by combined myocardial infarction and rapid ventricular pacing to VF in six normal dogs. A noncontact, multielectrode array balloon catheter provided full-surface real-time left ventricular (LV) endocardial electrograms and a dynamic color-coded display of endocardial activation projected onto a three-dimensional model of the LV. Fast Fourier transform (FFT) analysis of virtual electrograms showed no difference in peak or centroid frequency in CHF dogs compared with normals. The average number of simultaneous noncontiguous wavefronts present during VF was higher in normals (2.4 ± 1.0 at 10 s of VF) than in CHF dogs (1.3 ± 1.0, P < 0.005) and decreased in both over time. The wavefront “turnover” rate, estimated using FFT of the noncontiguous wavefront data, did not differ between normals and CHF and did not change over 5 min of VF. Thus the fundamental frequency characteristics of VF are unaltered by CHF, but dilated abnormal ventricles sustain fewer active wavefronts than do normal ventricles.

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Management of Ventricular Fibrillation during Acute Myocardial Infarction

Methods of Information in Medicine ◽

10.1055/s-0038-1635344 ◽

1984 ◽

Vol 23 (04) ◽

pp. 209-213

Author(s):

B. J. Northover

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Ventricular Fibrillation ◽

Coronary Care Unit ◽

Patient Survival ◽

Left Ventricular ◽

Ventricular Failure ◽

Before And After ◽

Coronary Care ◽

The Creation

SummaryAnalysis of electrocardiograms tape-recorded from patients admitted to hospital with acute myocardial infarction revealed that the pattern of ventricular extrasystolic activity was not significantly different among those who subsequently developed ventricular fibrillation and those who did not. Episodes of ventricular fibrillation occurred predominantly within 4 hours from the start of infarction. Patients were 3 times less likely to survive an episode of ventricular fibrillation if they also had left ventricular failure than if this feature was absent. Management of episodes of ventricular fibrillation was compared in patients before and after the creation of a specially staffed and equipped coronary care unit. The success of electric shock as a treatment for ventricular fibrillation was similar before and after the creation of the coronary care unit. An attempt was made to determine which features in the management of ventricular fibrillation in this and in previously published series were associated with patient survival.

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Quantitative analysis of left ventricular dyssynchrony using cardiac computed tomography versus three-dimensional echocardiography

European Radiology ◽

10.1007/s00330-011-2375-0 ◽

2012 ◽

Vol 22 (6) ◽

pp. 1303-1309 ◽

Cited By ~ 6

Author(s):

Sebastian J. Buss ◽

Felix Schulz ◽

David Wolf ◽

Waldemar Hosch ◽

Christian Galuschky ◽

...

Keyword(s):

Computed Tomography ◽

Quantitative Analysis ◽

Cardiac Computed Tomography ◽

Three Dimensional ◽

Left Ventricular ◽

Left Ventricular Dyssynchrony ◽

Ventricular Dyssynchrony ◽

Dimensional Echocardiography ◽

Three Dimensional Echocardiography

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Quantitative analysis of cardiac left ventricular variables obtained by MRI at 3 T: a pre- and post-contrast comparison

British Journal of Radiology ◽

10.1259/bjr/62891785 ◽

2012 ◽

Vol 85 (1015) ◽

pp. e343-e347 ◽

Cited By ~ 5

Author(s):

S Matthew ◽

S J Gandy ◽

R S Nicholas ◽

S A Waugh ◽

E A Crowe ◽

...

Keyword(s):

Quantitative Analysis ◽

Left Ventricular ◽

Post Contrast

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Mechanism of higher incidence of ischemic mitral regurgitation in patients with inferior myocardial infarction: Quantitative analysis of left ventricular and mitral valve geometry in 103 patients with prior myocardial infarction

Journal of Thoracic and Cardiovascular Surgery ◽

10.1067/mtc.2003.78 ◽

2003 ◽

Vol 125 (1) ◽

pp. 135-143 ◽

Cited By ~ 193

Author(s):

Toshiro Kumanohoso ◽

Yutaka Otsuji ◽

Shiro Yoshifuku ◽

Keiko Matsukida ◽

Chihaya Koriyama ◽

...

Keyword(s):

Myocardial Infarction ◽

Quantitative Analysis ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Left Ventricular ◽

Ischemic Mitral Regurgitation ◽

Inferior Myocardial Infarction ◽

Prior Myocardial Infarction ◽

Mitral Valve Geometry

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Glycolytic inhibition causes spontaneous ventricular fibrillation in aged hearts

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00128.2011 ◽

2011 ◽

Vol 301 (1) ◽

pp. H180-H191 ◽

Cited By ~ 32

Author(s):

Norishige Morita ◽

Jong-Hwan Lee ◽

Aneesh Bapat ◽

Michael C. Fishbein ◽

William J. Mandel ◽

...

Keyword(s):

Ventricular Fibrillation ◽

Connexin 43 ◽

Left Ventricular ◽

Triggered Activity ◽

Adult Rat ◽

Rat Hearts ◽

Intracellular Calcium Ion ◽

Dependent Protein ◽

Isolated Cardiac Myocytes ◽

Delayed Afterdepolarizations

Selective glycolytic inhibition (GI) promotes electromechanical alternans and triggered beats in isolated cardiac myocytes. We sought to determine whether GI promotes triggered activity by early afterdepolarization (EAD) or delayed afterdepolarizations in intact hearts isolated from adult and aged rats. Dual voltage and intracellular calcium ion (Cai2+) fluorescent optical maps and single cell glass microelectrode recordings were made from the left ventricular (LV) epicardium of isolated Langendorff-perfused adult (∼4 mo) and aged (∼24 mo) rat hearts. GI was induced by replacing glucose with 10 mM pyruvate in oxygenated Tyrode's. Within 20 min, GI slowed Cai2+ transient decline rate and shortened action potential duration in both groups. These changes were associated with ventricular fibrillation (VF) in the aged hearts (64 out of 66) but not in adult hearts (0 out of 18; P < 0.001). VF was preceded by a transient period of focal ventricular tachycardia caused by EAD-mediated triggered activity leading to VF within seconds. The VF was suppressed by the ATP-sensitive K (KATP) channel blocker glibenclamide (1 μM) but not (0 out of 7) by mitochondrial KATP block. The Ca-calmodulin-dependent protein kinase II (CaMKII) blocker KN-93 (1 μM) prevented GI-mediated VF ( P < 0.05). Block of Na-Ca exchanger (NCX) by SEA0400 (2 μM) prevented GI-mediated VF (3 out of 6), provided significant bradycardia did not occur. Aged hearts had significantly greater LV fibrosis and reduced connexin 43 than adult hearts ( P < 0.05). We conclude that in aged fibrotic unlike in adult rat hearts, GI promotes EADs, triggered activity, and VF by activation of KATP channels CaMKII and NCX.

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Ventricular Fibrillation After Release of an Aortic Cross-Clamp in Valvular Surgery: Independent Risk Factors, Outcomes, and Incidence from Access Routes

10.21203/rs.3.rs-697996/v1 ◽

2021 ◽

Author(s):

Weichao LI ◽

heng li ◽

Jianping Gong ◽

Weihua Liu ◽

BaoJun Fu ◽

...

Keyword(s):

Risk Factors ◽

Ventricular Fibrillation ◽

Clinical Outcomes ◽

Valve Replacement ◽

Smoking Status ◽

Left Ventricular ◽

Aortic Cross Clamp ◽

Valvular Surgery ◽

Htk Solution ◽

Independent Risk Factors

Abstract Background Predictors and clinical outcomes of VF-ACC and the relative VF-ACC incidence with various access routes have not been well documented. This study aimed to identify predictors, clinical outcomes, and relative incidences of ventricular fibrillation after the release of an aortic cross-clamp (VF-ACC) with various access routes in valvular surgery.Patients and methods In this single-center and retrospective cohort study, we screened 228 consecutive patients undergoing valve surgery, and a total of 119 patients were included in the study. The primary outcomes were the relative incidence and predictors of VF-ACC with access routes, and secondary endpoints included effects of VF-ACC on 30-day mortality, perioperative ventricular arrhythmias (VAs), and heart failure with ejection fraction < 50% (HFEF < 50%).Results VF-ACC incidence varied on the basis of access routes. VF-ACC occurred in 58.3% of patients with aortic valve replacement via transverse aortotomy (TAo-AVR), in 48.6% of patients with aortic and mitral replacements via transseptal and transverse aortotomy access (TSAo-MAVR), and in 20% of patients with mitral valve replacement via transseptal access (TS-MVR). Seven independent risk factors were identified: HTK solution (AOR: 4.90, p = 0.002), smoking status (AOR: 6.30, p = 0.001), cerebrovascular disease (CBD) [(AOR: 7.08, p = 0.022)], regional wall motion abnormality (RWMA) [(AOR: 8.33, p < 0.001)], perioperative VAs (AOR: 4.85, p = 0.001), HFEF < 50% (AOR: 5.66, p = 0.002), and left ventricular mass index (LVMI) [(AOR: 0.962, CI: 0.941–0.984)].Conclusions VF-ACC was the most common in TAo-AVR and the least common in TS-MVR. HTK solution, smoking status, CBD, perioperative VAs, HFEF < 50%, and RWMA were associated with an increased risk of VF-ACC, and low LVMI acted as a protective factor. Patients with VF-ACC commonly experienced perioperative VAs or HFEFs < 50%.Clinical trial registration: ChiCTR2100050961.

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