Cellular electrophysiologic mechanisms of cardiac arrhythmias.

Cardiac arrhythmias are caused by alterations in the electrophysiologic properties of the cardiac cells, which affect the characteristics of the transmembrane potentials. The electrophysiologic properties that cause arrhythmias are automaticity, triggered activity, and reentrant excitation. Each of these mechanisms is described in terms of the characteristics of the transmembrane potentials and how these influence the appearance of the arrhythmia on the electrocardiogram.

Mechanisms causing sustained ventricular tachycardia with multiple QRS morphologies: results of mapping studies in the infarcted canine heart.

Background: Sustained reentrant ventricular tachycardias (VTs) with different QRS morphologies have been observed to occur spontaneously and during programmed stimulation in human hearts. We determined mechanisms that can cause tachycardias with multiple morphologies in a canine model of myocardial infarction by mapping reentrant circuits.

Methods And Results: Reentrant VT with multiple QRS morphologies was induced in 11 canine hearts with 4-day-old infarcts.

Tissue reactions to bacteria-inoculated rat lead samples. II. Effect of local gentamicin release through surface-modified polyurethane tubing.

A surface modification technique was developed to achieve controlled release of gentamicin from implanted polyurethane (PU) rat lead samples. PU tubing first was provided with an acrylic acid/acrylamide copolymer surface graft and then loaded with gentamicin. This surface modification technique resulted in release of gentamicin base (GB) and was applied either to the inner luminal surface only (PU-GB-1x) or to both the inner and outer surfaces (PU-GB-2x).

Tissue reactions to bacteria-inoculated rat lead samples. I. Effect of local gentamicin release through vicinal sponge or solution-dipping.

The effect of local gentamicin release through a vicinal collagen sponge or through preoperative solution-dipping of rat lead samples was investigated in an early-infection model. The efficacy of these methods and their effect on tissue response were determined. It was demonstrated that both methods of local gentamicin release suppress lead-related infectious complications as compared to the control lead, which showed a high presence of inflamed/infected tissues and bacterial growth at each explantation time point.

Disturbed connexin43 gap junction distribution correlates with the location of reentrant circuits in the epicardial border zone of healing canine infarcts that cause ventricular tachycardia.

Background: Slow, nonuniform conduction caused by abnormal gap-junctional coupling of infarct-related myocardium is thought to be a component of the arrhythmogenic substrate. The hypothesis that changes in gap-junctional distribution in the epicardial border zone (EBZ) of healing canine infarcts define the locations of reentrant ventricular tachycardia (VT) circuits was tested by correlating activation maps of the surviving subepicardial myocardial layer with immunolocalization of the principal gap-junctional protein, connexin43 (Cx43).

Methods And Results: The EBZ overlying 4-day-old anterior infarcts in three dogs with inducible VT and three noninducible dogs was mapped with a high-resolution electrode array and systematically examined by standard histology and confocal immunolocalization of Cx43.

Electrophysiological effects of flecainide on anisotropic conduction and reentry in infarcted canine hearts.

Background: The class IC antiarrhythmic drug flecainide has been shown to be ineffective for the treatment of ventricular arrhythmias in some patients who have had a prior myocardial infarction and sometimes even provoke arrhythmias (proarrhythmic effect). Since some ventricular tachycardias may be caused by anisotropic reentry, we determined the effects of flecainide on this mechanism for reentry in infarcted canine hearts in order to determine possible causes for its clinical effects.

Methods And Results: The effects of flecainide were determined on ventricular tachycardia induced by programmed electrical stimulation in dogs with healing myocardial infarction 4 days after coronary artery occlusion.

The effectiveness of a pendulum swing for the development of leg strength and counter-movement jump performance.

Various training devices have been developed to facilitate 'plyometric' training, one such device being the 'pendulum swing'. To assess the effectiveness of the pendulum swing, the results of a 3 week training programme using a combination of pendulum swing and weight-training exercises were compared to those of a weight-training programme. Subjects were assigned to one of two groups (n = 9) for weight-training only or for combined pendulum and weight-training.

Prediction of the location and time of spontaneous termination of reentrant ventricular tachycardia for radiofrequency catheter ablation therapy.

Ventricular tachycardia caused by reentrant excitation can lead to cardiac arrest and sudden death. Drug treatment and surgical procedures have been used with limited effectiveness. Catheter ablation methods are more promising because they are less invasive than surgery.

Forearm tremor in relation to selected physiological and body dimensional variables.

Interrelationships between forearm tremor and a number of body dimensional, muscle structure, muscular strength and training background variables were studied among 13 male students with athletic backgrounds. The subjects performed isometric dominant upper extremity elbow flexions with a 90 degrees joint angle and with the forearm held in a horizontal position. A freely hanging mass was attached via a strain gauge transducer, a metal chain and cuff to the forearm.

Localized spatial discrimination of epicardial conduction paths after linear transformation of variant information.

We present a method for the localized statistical discrimination of class populations based on the Karhunen-Loève and Fukunaga-Koontz transforms. These transforms provide features that model the variance of a sample distribution. The spatial series of a 196 channel epicardial electrogram recording from an arrythmogenic postinfarct canine were analyzed.

Forearm tremor during three different isometric loadings.

Forearm tremor was studied during a spring (stiffness 1090 N.m-1), a rigid isometric and a "dynamic" isometric (carrying a freely hanging mass) loading at the level of 50% of maximal isometric voluntary contraction. Thirteen physical education students ranging in age between 20 and 28 years flexed their dominant forearm isometrically towards the vertical direction (90 degree elbow angle) against the three different loads on three test occasions seated on a dynamometer which measured the force at the wrist together with vertical tremor (accelerometer).

Effects of neutralization of pregnant mares' serum gonadotrophin (PMSG) shortly before or at the preovulatory LH surge in PMSG-superovulated heifers on follicular function and development.

Normally cyclic heifers (n = 34) received 2500 iu pregnant mares' serum gonadotrophin (PMSG) i.m. at day 10 of oestrus, and 15 mg prostaglandin (PG) i.

Spontaneous activity in transgenic mouse heart: comparison of primary atrial tumor with cultured AT-1 atrial myocytes.

Introduction: We have generated transgenic animals that heritably develop atrial tumors composed of differentiated proliferating cardiomyocytes. Experiments were initiated to characterize the electrical properties of these cells.

Methods And Results: We show that the primary atrial tumors are composed of discrete foci that exhibit spontaneous automatic activity.

Role of alterations in refractoriness and conduction in the genesis of reentrant arrhythmias. Implications for antiarrhythmic effects of class III drugs.

Despite the fact that a number of different electrophysiologic mechanisms are capable of causing cardiac arrhythmias, reentrant excitation has emerged as the most important mechanism causing life-threatening arrhythmias that arise in the ventricles. Pharmacologic therapy of arrhythmias caused by reentry is aimed at preventing the conditions that either facilitate the initiation of the circulating reentrant excitation wave or the conditions that permit its persistence. This involves alterations in either refractoriness or conduction by the drugs.

Effects of overdrive stimulation on functional reentrant circuits causing ventricular tachycardia in the canine heart: mechanisms for resumption or alteration of tachycardia.

Introduction: The purpose of the experiments described in this article was to investigate the effects of overdrive stimulation on functional anisotropic reentrant circuits causing ventricular tachycardia in infarcted canine ventricles. We determined how overdrive stimuli affect reentrant circuits to alter characteristics of the tachycardia.

Methods And Results: Activation patterns were determined by mapping excitation with a 192 bipolar electrode array.

Overdrive stimulation of functional reentrant circuits causing ventricular tachycardia in the infarcted canine heart. Resetting and entrainment.

Background: Clinical electrophysiology studies have used, for the most part, models of anatomic reentrant circuits to explain entrainment of ventricular tachycardia. Our studies use activation maps to directly determine mechanisms of entrainment of functional circuits that cause tachycardia.

Methods And Results: Electrograms were recorded from 192 sites on reentrant circuits in the epicardial border zone of canine myocardial infarcts during sustained ventricular tachycardia.

Reentrant circuits and the effects of heptanol in a rabbit model of infarction with a uniform anisotropic epicardial border zone.

Introduction: The purpose was to study reentry in a rabbit model of infarction.

Methods And Results: A model of an infarct epicardial border zone was produced in Langendorff perfused rabbit hearts by freezing the inner two thirds of the left ventricular wall, allowing only a thin epicardial muscle layer to survive. Reentrant circuits causing stable ventricular tachycardia occurred in the surviving rim of epicardial muscle as shown by mapping impulse propagation with a 196-electrode array.

Skin vascular reactivity in healthy subjects: influence of hormonal status.

To investigate the influence of the hormonal status on skin vascular reactivity, 18 males, 18 women using oral contraceptives (oc), 17 premenopausal, and 18 postmenopausal women were studied. Finger skin temperature (FST, in degrees C) and laser Doppler flux (LDF, in perfusion units) were measured during heating (45 degrees C water bath) and cooling (15 degrees C) followed by a subsequent recovery period. Maximal heat-induced vasodilation was significantly higher in women using oc and in premenopausal women when compared with males.