Capture of activation during ventricular arrhythmia using distributed stimulation. 2007

Jason M Meunier, and Sanjiv Ramalingam, and Shien-Fong Lin, and Abhijit R Patwardhan
2 Wenner-Gren Research Laboratory, The Center for Biomedical Engineering, The University of Kentucky, Lexington, KY 40506-0070, USA.

Results of previous studies suggest that pacing strength stimuli can capture activation during ventricular arrhythmia locally near pacing sites. The existence of spatio-temporal distribution of excitable gap during arrhythmia suggests that multiple and timed stimuli delivered over a region may permit capture over larger areas. OBJECTIVE Our objective in this study was to evaluate the efficacy of using spatially distributed pacing (DP) to capture activation during ventricular arrhythmia. METHODS Data were obtained from rabbit hearts which were placed against a lattice of parallel wires through which biphasic pacing stimuli were delivered. Electrical activity was recorded optically. Pacing stimuli were delivered in sequence through the parallel wires starting with the wire closest to the apex and ending with one closest to the base. Inter-stimulus delay was based on conduction velocity. Time-frequency analysis of optical signals was used to determine variability in activation. A decrease in standard deviation of dominant frequencies of activation from a grid of locations that spanned the captured area and a concurrence with paced frequency were used as an index of capture. RESULTS Results from five animals showed that the average standard deviation decreased from 0.81 Hz during arrhythmia to 0.66 Hz during DP at pacing cycle length of 125 ms (p = 0.03) reflecting decreased spatio-temporal variability in activation during DP. Results of time-frequency analysis during these pacing trials showed agreement between activation and paced frequencies. CONCLUSIONS These results show that spatially distributed and timed stimulation can be used to modify and capture activation during ventricular arrhythmia.

UI MeSH Term Description Entries
D011817 Rabbits A burrowing plant-eating mammal with hind limbs that are longer than its fore limbs. It belongs to the family Leporidae of the order Lagomorpha, and in contrast to hares, possesses 22 instead of 24 pairs of chromosomes. Belgian Hare,New Zealand Rabbit,New Zealand Rabbits,New Zealand White Rabbit,Rabbit,Rabbit, Domestic,Chinchilla Rabbits,NZW Rabbits,New Zealand White Rabbits,Oryctolagus cuniculus,Chinchilla Rabbit,Domestic Rabbit,Domestic Rabbits,Hare, Belgian,NZW Rabbit,Rabbit, Chinchilla,Rabbit, NZW,Rabbit, New Zealand,Rabbits, Chinchilla,Rabbits, Domestic,Rabbits, NZW,Rabbits, New Zealand,Zealand Rabbit, New,Zealand Rabbits, New,cuniculus, Oryctolagus
D002304 Cardiac Pacing, Artificial Regulation of the rate of contraction of the heart muscles by an artificial pacemaker. Pacing, Cardiac, Artificial,Artificial Cardiac Pacing,Artificial Cardiac Pacings,Cardiac Pacings, Artificial,Pacing, Artificial Cardiac,Pacings, Artificial Cardiac
D005260 Female Females
D006352 Heart Ventricles The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation. Cardiac Ventricle,Cardiac Ventricles,Heart Ventricle,Left Ventricle,Right Ventricle,Left Ventricles,Right Ventricles,Ventricle, Cardiac,Ventricle, Heart,Ventricle, Left,Ventricle, Right,Ventricles, Cardiac,Ventricles, Heart,Ventricles, Left,Ventricles, Right
D000200 Action Potentials Abrupt changes in the membrane potential that sweep along the CELL MEMBRANE of excitable cells in response to excitation stimuli. Spike Potentials,Nerve Impulses,Action Potential,Impulse, Nerve,Impulses, Nerve,Nerve Impulse,Potential, Action,Potential, Spike,Potentials, Action,Potentials, Spike,Spike Potential
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001145 Arrhythmias, Cardiac Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction. Arrhythmia,Arrythmia,Cardiac Arrhythmia,Cardiac Arrhythmias,Cardiac Dysrhythmia,Arrhythmia, Cardiac,Dysrhythmia, Cardiac
D022062 Electrophysiologic Techniques, Cardiac Methods to induce and measure electrical activities at specific sites in the heart to diagnose and treat problems with the heart's electrical system. Cardiac Electrophysiologic Techniques,Electrophysiologic Study, Cardiac,Atrial Electrogram,Bundle of His Electrogram,Cardiac Electrophysiologic Technics,Cardiac Electrophysiological Techniques,Electrophysiologic Techniques, Intracardiac,Electrophysiological Techniques, Cardiac,Electrophysiological Techniques, Intracardiac,His Bundle Electrogram,Intra-Atrial Electrogram,Intracardiac Electrogram,Intracardiac Electrophysiologic Techniques,Intracardiac Electrophysiological Technics,Intracardiac Electrophysiological Techniques,Programmed Electrostimulation, Cardiac,Transesophageal Electrophysiologic Study,Transesophageal Electrophysiological Study,Atrial Electrograms,Bundle Electrogram, His,Bundle Electrograms, His,Cardiac Electrophysiologic Studies,Cardiac Electrophysiologic Study,Cardiac Electrophysiologic Technic,Cardiac Electrophysiologic Technique,Cardiac Electrophysiological Technique,Cardiac Programmed Electrostimulation,Cardiac Programmed Electrostimulations,Electrogram Bundle, His,Electrogram Bundles, His,Electrogram, Atrial,Electrogram, His Bundle,Electrogram, Intra-Atrial,Electrogram, Intracardiac,Electrograms, Atrial,Electrograms, His Bundle,Electrograms, Intra-Atrial,Electrograms, Intracardiac,Electrophysiologic Studies, Cardiac,Electrophysiologic Studies, Transesophageal,Electrophysiologic Study, Transesophageal,Electrophysiologic Technic, Cardiac,Electrophysiologic Technics, Cardiac,Electrophysiologic Technique, Cardiac,Electrophysiologic Technique, Intracardiac,Electrophysiological Studies, Transesophageal,Electrophysiological Study, Transesophageal,Electrophysiological Technic, Intracardiac,Electrophysiological Technics, Intracardiac,Electrophysiological Technique, Cardiac,Electrophysiological Technique, Intracardiac,Electrostimulation, Cardiac Programmed,Electrostimulations, Cardiac Programmed,His Bundle Electrograms,His Electrogram Bundle,His Electrogram Bundles,Intra Atrial Electrogram,Intra-Atrial Electrograms,Intracardiac Electrograms,Intracardiac Electrophysiologic Technique,Intracardiac Electrophysiological Technic,Intracardiac Electrophysiological Technique,Programmed Electrostimulations, Cardiac,Studies, Cardiac Electrophysiologic,Studies, Transesophageal Electrophysiologic,Studies, Transesophageal Electrophysiological,Study, Cardiac Electrophysiologic,Study, Transesophageal Electrophysiologic,Study, Transesophageal Electrophysiological,Technic, Cardiac Electrophysiologic,Technic, Intracardiac Electrophysiological,Technics, Cardiac Electrophysiologic,Technics, Intracardiac Electrophysiological,Technique, Cardiac Electrophysiologic,Technique, Cardiac Electrophysiological,Technique, Intracardiac Electrophysiologic,Technique, Intracardiac Electrophysiological,Techniques, Cardiac Electrophysiologic,Techniques, Cardiac Electrophysiological,Techniques, Intracardiac Electrophysiologic,Techniques, Intracardiac Electrophysiological,Transesophageal Electrophysiologic Studies,Transesophageal Electrophysiological Studies

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