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At least 163 records · Page 9Linked to original sources
PubMed2000

Right pulmonary vein potentials recorded from the posterior right atrial endocardium: human case report and validation in a porcine model.

A 33-year-old woman underwent successful catheter ablation of an atrial tachycardia emanating from deep within a large right superior pulmonary vein (RSPV). A previous ablation attempt in this patient had failed, during which radiofrequency energy applications were made to the posterior right atrium only. The mistaken impression of a right atrial source for this tachycardia was due to RSPV potentials that were recorded during mapping in a region of the posterior right atrium contiguous to the vein ("contiguity region"). To further evaluate this, we performed activation mapping and radiofrequency ablation in atria of healthy pigs. Similar to the reported case, "biatrial" potentials were recorded from both left and right aspects of the contiguity region. Radiofrequency energy application altered only the potential emanating from the atrium in which the lesion was applied. Histologic analysis confirmed that the lesion was limited to this atrium. It is concluded that, due to their proximity, electrical activity in the RSPV may be recorded from certain areas of the posterior right atrium, and vice versa. In the reported case of left atrial tachycardia, this led to the mistaken impression of right atrial tachycardia.

Adult↗
PubMedDate not supplied

Mechanical contribution of endocardium during finite extension and torsion experiments on papillary muscles.

Finite extension and torsion tests on cardiac papillary muscles are presently the best way to directly measure the response to shear along myocardial fibers. Quantifying this response is necessary for determining the complete three-dimensional constitutive behavior of myocardium as a transversely isotropic material. Analysis of such tests is complicated, however, since papillary muscles are materially inhomogeneous, consisting of a myocardial core surrounded by an endocardial sheath that is rich in collagen. In this article, we show that the papillary muscle response to extension and torsion additively decouples into the response of the bare myocardial core plus the response of an endocardial sheath filled with fluid (assuming the muscle is a radially inhomogeneous and incompressible continuum with cylindrical symmetry). This result allows the endocardial response to be subtracted from the intact papillary muscle response to obtain the response of the bare myocardial core. An initial estimate suggests that the endocardial sheath affects the axial moment significantly (50% of torque for all twists at low stretch) but affects the axial force only slightly (<10% at moderate twists).

Animals↗
PubMed1992

Electrical restitution in the endocardium of the intact human right ventricle.

OBJECTIVE: To characterise electrical restitution in the intact human heart. PATIENTS AND METHODS: A series of monophasic action potential electrical restitution curves were constructed from a single right ventricular endocardial site in eight patients (three men) without structural heart disease aged 52-68 (mean 55 years). A combination pacing/monophasic action potential electrode was used to pace and record monophasic action potentials at drive cycle lengths of from 350 ms to 1500 ms. Ventricular extrastimuli were delivered at 20 cycle intervals and decreased from the longest coupling interval attainable without escape beats. RESULTS: Restitution curves shifted downward and towards the left; steady state action potential duration shifted from the restitution plateau and descended the curve, the amount of shift being linearly related to drive cycle length in two patients in whom the relation could be assessed; the amount of monophasic action potential shortening was a function of the degree of prematurity and that relation was unaffected by drive rate; the magnitude of restitution and the time constant of the restitution curve were not changed significantly by altered drive cycle length. CONCLUSION: In the intact heart in vivo, electrical restitution (of the monophasic action potential) has similar characteristics to those (of the transmembrane action potential) in cellular preparations in vitro. Thus the alteration of action potential plateau currents by instantaneous rate change or drug effects, which can be directly observed by techniques available to the cellular electrophysiologist, may be indirectly assessed in vivo by characterisation of the effect of these on electrical restitution.

Action Potentials↗
PubMed1989

The endocardium.

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Animals↗
PubMed1977

Responses of canine endocardium to stimulation of the upper thoracic roots.

In each of 10 mongrel dogs anesthetized with alpha chloralose, strain-gauge arches were sutured to five epicardial and three endocardial locations. Comparisons of contractile force responses during stimulation of the left and right roots of the same segmental level revealed several differences dependent upon the particular myocardial area observed. Of the three left ventricular endocardial areas studied, the interventricular septum was the most responsive, particularly during stimulation of the right roots. The basal free wall and posterior papillary muscle were more responsive to left-root than to right-root stimulations. Epicardial responses were consistent with those previously reported. Generally, all areas responded to the greatest degree during stimulation of the second roots with the third and first next in order of effectiveness. Although stimulation of each level of preganglionic outflow activated all epicardial and endocardial segments of the myocardium, the magnitude of the changes in contractile force were highly variable dependent upon the specific level of preganglionic outflow and the location of the strain-gauge arch.

Animals↗
PubMed1996

Different responses of epicardium and endocardium to KATP channel modulators during regional ischemia.

We examined the responses of epicardial (Epi) and endocardial (Endo) layers to ATP-sensitive K+ (KATP) channel modulators during regional ischemia in anesthetized dogs. Five-minute occlusion of the left anterior descending coronary artery was repeated at 30-min interval. Monophasic action potentials (MAPs) and extracellular K+ concentrations ([K+]o) were measured at Epi and Endo layers. 5-Hydroxydecanoate (5-HD, 30 mg/kg iv), a KATP channel blocker, or nicorandil (NCR, 0.2-0.5 mg/kg iv), an opener, was administered before the third or fourth occlusion. Shortening rate of action potential duration at 90% repolarization (APD90) was greater at the Epi layer than at the Endo layer during the first 4 min after the second control occlusion (19.7 +/- 1.5 vs. 13.1 +/- 2.4%, n = 14, P < 0.05). 5-HD suppressed the shortening preferentially at the Epi layer and reduced the difference between the two layers (11.0 +/- 3.5 vs. 11.5 +/- 3.7%, n = 6, NS). In contrast, NCR augmented the shortening preferentially at the Epi layer and increased the difference between the two layers at 4 min (29.0 +/- 2.0 vs. 5.9 +/- 3.0%, n = 6, P < 0.05). The time differentiation of [K+]o rise was similar at the two layers during the control occlusion (0.44 vs. 0.50 mM/min, n = 12). 5-HD reduced the rate of [K+]o rise at both layers (0.34 vs. 0.40 mM/min), whereas NCR augmented the rate at the Epi layer (0.82 vs. 0.50 mM/min). Activation of KATP channels appears to be involved in ischemia-induced APD shortening and [K+]o rise. The different responses of the two layers suggest a lower threshold for activation and/or a denser distribution of KATP channels or other K+ channels at the Epi layer.

Action Potentials↗
PubMed1986

Simultaneous recording of action potentials from endocardium and epicardium during ischemia in the isolated cat ventricle: relation of temporal electrophysiologic heterogeneities to arrhythmias.

We studied the effects of ischemia on transmembrane action potentials, conduction time, and refractory periods of both endocardial and epicardial muscle cells of coronary-perfused cat left ventricles. Oxygenated Tyrode's solution was perfused through the left anterior descending coronary artery, while the preparation was superfused with Tyrode's solution gassed with 95% N2 and 5% CO2. Transmembrane action potentials recorded simultaneously from endocardial and epicardial cells were normal during coronary perfusion. When perfusion was discontinued ("ischemia"), rapid deterioration of action potentials and prolongation of conduction time were observed in both endocardial and epicardial cells. The magnitude of the reduction of action potential amplitude and action potential duration (APD), and of prolongation of conduction time, was greater in epicardial cells than in endocardial cells, although the change in resting membrane potential was almost the same. However, APD of endocardial cells decreased progressively during 30 min of ischemia, whereas APD of epicardial cells was reduced maximally at 10 min and then partially recovered. Shortening of refractory periods of endocardial cells paralleled APD shortening, whereas refractory periods of epicardial cells decreased for the first 10 min and then increased. At 10 min of ischemia, APD and refractory periods of epicardial cells were significantly shorter than those of endocardial cells. At 30 min of ischemia, refractory periods of epicardial cells exceeded those of endocardial cells because of development of greater postrepolarization refractoriness in epicardial cells. Accompanying these different changes in APD and refractory periods of endocardial and epicardial cells, spontaneous extrasystolic impulses increased and rapid runs of extrasystolic impulses could be induced by extrastimuli.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1996

Regional differences in electrophysiological properties of epicardium, midmyocardium, and endocardium. In vitro and in vivo correlations.

BACKGROUND: Microelectrode studies have described a population of cells within the midmyocardium (M cells) displaying a steep rate dependence of action potential duration (APD) and high Vmax compared with endocardial (Endo) and epicardial (Epi) cells. METHODS AND RESULTS: We studied repolarization in different myocardial layers in vitro and in situ. In addition to confirming the results of earlier studies, we found that after abrupt lengthening of the cycle length (CL), APDs in M cells reached a new steady state faster than in Epi or Endo cells: the time to achieve 90% of the difference in APD (t90) was 13.3 +/- 0.7 minutes in Endo cells, 12.8 +/- 1.1 minutes in Epi cells, and 2.6 +/- 0.4 minutes in M cells (P < .05 compared with Epi or Endo) when CL changed from 400 to 1000 ms. In situ, we registered activation-recovery intervals (ARIs) in bipolar electrograms obtained from different myocardial layers in conditions of AV block and His-bundle pacing. At all CLs from 300 to 2000 ms, ARIs were equal in all myocardial layers from Epi to Endo cells. Steady-state ARIs coincided with APD of M cells registered in vitro in the physiological range of CL from 300 to 700 ms. When CL was changed from 300 to 1000 ms, the ARI followed the rapid time course typical of M cells (t90 = 2.6 +/- 0.5, 2.2 +/- 0.4, 2.5 +/- 0.4, 2.6 +/- 0.5, and 2.3 +/- 0.4 minutes for Epi; 3-, 5-, and 7-mm sub-Epi; and Endo cells, respectively). CONCLUSIONS: In contrast to in vitro results, there is no significant difference in repolarization among myocardial layers in the intact normal canine heart.

Action Potentials↗
PubMed1997

Activation-repolarization coupling in the normal swine endocardium.

BACKGROUND: While abnormalities of activation and repolarization play an important role in arrhythmogenesis, little information is available on the interaction between their spatial dispersions in the heart. This study examined the effects of activation spread on the spatial distribution of the repolarization properties during different depolarization patterns. METHODS AND RESULTS: Left ventricular (LV) endocardial activation and repolarization patterns were mapped in 13 healthy pigs. LV local activation, repolarization, and activation-recovery interval (ARI) times were determined from the intracardiac unipolar electrograms, color-coded, and superimposed on a three-dimensional anatomic map of the ventricle generated with a nonfluoroscopic mapping system. ARI values correlated with the duration of monophasic activation potential recorded from onset of activation to time of 90% repolarization (r=.97, P<.01). Activation time range of the left ventricle was 42+/-5 ms (mean+/-SEM) during sinus rhythm and 54+/-5 ms during right ventricular septal pacing. ARI inversely correlated with the corresponding activation times during both sinus (r2=.76+/-.03) and paced (r2=.77+/-.02) rhythms. The longest ARIs were located at the sites of earliest activation and shortest at the latest activation areas, with gradual shortening between them. CONCLUSIONS: The spatial distribution of repolarization is dependent on the activation pattern. Repolarization dispersion in the healthy swine heart is relatively small as the result of tight coupling of the action potential duration to the activation process, assigning longer ARIs to sites activated earlier. This coupling reduces global and regional dispersion of repolarization and may serve as an important antiarrhythmic mechanism present in normal myocardium.

Animals↗
PubMed2004

Contribution of IKr to rate-dependent action potential dynamics in canine endocardium.

Previous modeling studies have suggested that the rapid component of the delayed rectifier (I(Kr)) may contribute importantly to action potential dynamics during tachycardia. To test this idea experimentally, I(Kr) was measured as the E-4031-sensitive current in isolated canine endocardial myocytes at 37 degrees C using the perforated patch-clamp technique. Command potentials were trains of action potential waveforms recorded at cycle lengths (CLs) of 1000, 500, 320, 170, and 120 ms. Action potential duration (APD) alternans occurred at CLs of 170 and 120 ms. During an action potential, I(Kr) increased gradually to a maximum at -55 to -60 mV. Peak I(Kr) increased initially as CL was shortened from 1000 to 500 ms (from 0.55+/-0.03 to 0.57+/-0.03 pA/pF), but decreased progressively as CL was shortened further (to 0.45+/-0.03 pA/pF at CL=120 ms). Baseline I(Kr) was negligible at CLs of 1000 to 320 ms, but increased to 0.12+/-0.01 pA/pF at a CL of 120 ms. During APD alternans, peak I(Kr) was larger for the short than for the long action potential (0.48+/-0.03 versus 0.46+/-0.03 pA/pF). A computer model of I(Kr) based on these data indicated that increasing I(Kr) suppressed alternans and decreasing I(Kr) increased alternans. In support of the latter result, inhibition of I(Kr) by E-4031 increased the maximal amplitude of alternans. These results indicate that I(Kr) contributes importantly to rate-related alterations of repolarization, including APD alternans. Modifying I(Kr) may be a promising approach to suppressing alternans and thereby preventing ventricular tachyarrhythmias.

Action Potentials↗