Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2014.55.121
Endocardial focal activation originating from Purkinje fibers plays a role in the maintenance of long duration ventricular fibrillation
Changjian Lin
; Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai, Jiao Tong University School Medicine, Shanghai, P.R. China of
Sažetak
Aim To determine the role of repetitive endocardial focal
activations and Purkinje fibers in the maintenance of long
duration ventricular fibrillation (LDVF, VF>1 minute) in canine
hearts in vivo.
Methods The study was conducted in electrophysiological
laboratory of Shanghai Ruijin hospital from July 2010
to August 2012. A 64-electrode basket was introduced
through a carotid artery into the left ventricle (LV) of 11
beagle dogs for global endocardial electrical mapping. In
the Lugol’s solution group (n = 5), the subendocardium was
ablated by washing with Lugol’s solution. In the control
group, (n = 6) saline was used for ablation. Before and after
saline or Lugol ablation, we determined QRS duration and
QT/QTc interval in sinus rhythm (SR). We also measured the
activation rates in the first 2 seconds of each minute during
7 minutes of VF for each group. If VF terminated spontaneously
in less than 7 minutes, the VF segments used in
activation rate analysis were reduced accordingly.
Results At the beginning of VF there was no difference
between the groups in the activation rate. However, after
1 minute of LDVF the Lugol’s solution group had significantly
slower activation rate than the control group. In the
control group, all episodes of LDVF (6/6) were successfully
sustained for 7 minutes, while in the Lugol’s solution group
4/5 episodes of LDVF spontaneously terminated before 7
minutes (4.8 ± 1.4 minutes) (P = 0.015). In the control group,
at 5.1 ± 1.3 minutes of LDVF, a successive, highly organized
focal LV endocardial activation pattern was observed. During
this period, activations partly arose in PF and spread
to the working ventricular myocardium. Mapping analysis
showed that these events were consistent with repetitive
endocardial focal activations. No evidence of similar focal
activations was observed in the Lugol’s solution group.
Conclusions Repetitive endocardial focal activations in
the LV endocardium may be associated with activation of
subendocardial PFs. This mechanism may play an important
role in the maintenance of LDVF.
Ključne riječi
Hrčak ID:
127277
URI
Datum izdavanja:
15.4.2014.
Posjeta: 1.048 *