Abstract
Background: It is recognized that a ventricular vulnerability period exists during which atrial shock delivery may induce a ventricular tachyarrhythmia. This study was designed to define the zone in which the ventricles are vulnerable to induction of ventricular tachyarrhythmia during delivery of atrial shocks in the sterile pericarditis canine model of atrial fibrillation. Methods and Results: Two days after creation of sterile pericarditis, 24 dogs underwent either a four-part or five-part ventricular vulnerability protocol during which atrial shocks were delivered between transvenous catheters, one in the distal coronary sinus and one in the right atrial appendage. The protocol included part 1, shocks during induced atrial fibrillation; parts 2 through 4, shocks delivered synchronously with the last ventricular beat of one of the following three ventricular pacing protocols: constant ventricular rates (S1S1), short-long-short cycles (S1S2S3-V), and ventricular premature bears (S1); and part 5, shocks delivered synchronously with the last R wave resulting from an atrially paced short- long-short cycle (S1S2S3A). Ventricular tachyarrhythmia was induced 122 times: 2 of 665 shocks in two dogs in part 1, 29 of 786 shocks in nine dogs in part 2, 67 of 734 shocks in 15 dogs in part 3, 24 of 919 shocks in five dogs in part 4, and none in part 5. All ventricular proarrhythmia resulted from shocks delivered during the T wave of a preceding ventricular beat. No episodes of ventricular tachyarrhythmia were induced by atrial shocks synchronized to R waves with the previous RR at intervals above the QT+60 ms interval (absolute interval >320 ms), with one exception, at the QT+ 100 ms interval (absolute interval 360 ms). Conclusions: With transvenous electrode catheters used to deliver atrial shocks, life-threatening ventricular rhythms were induced but were limited to a specific zone defined by the QT interval.
| Original language | English |
|---|---|
| Pages (from-to) | 1343-1350 |
| Number of pages | 8 |
| Journal | Circulation |
| Volume | 96 |
| Issue number | 4 |
| State | Published - Aug 19 1997 |
| Externally published | Yes |
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Keywords
- Atrium
- Defibrillation
- Fibrillation
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Safety of transvenous atrial defibrillation : Studies in the canine sterile pericarditis model. / Sokoloski, Mary C; Ayers, Gregory M.; Kumagai, Koichiro; Khrestian, Celeen M.; Niwano, Shinichi; Waldo, Albert L.
In: Circulation, Vol. 96, No. 4, 19.08.1997, p. 1343-1350.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Safety of transvenous atrial defibrillation
T2 - Studies in the canine sterile pericarditis model
AU - Sokoloski, Mary C
AU - Ayers, Gregory M.
AU - Kumagai, Koichiro
AU - Khrestian, Celeen M.
AU - Niwano, Shinichi
AU - Waldo, Albert L.
PY - 1997/8/19
Y1 - 1997/8/19
N2 - Background: It is recognized that a ventricular vulnerability period exists during which atrial shock delivery may induce a ventricular tachyarrhythmia. This study was designed to define the zone in which the ventricles are vulnerable to induction of ventricular tachyarrhythmia during delivery of atrial shocks in the sterile pericarditis canine model of atrial fibrillation. Methods and Results: Two days after creation of sterile pericarditis, 24 dogs underwent either a four-part or five-part ventricular vulnerability protocol during which atrial shocks were delivered between transvenous catheters, one in the distal coronary sinus and one in the right atrial appendage. The protocol included part 1, shocks during induced atrial fibrillation; parts 2 through 4, shocks delivered synchronously with the last ventricular beat of one of the following three ventricular pacing protocols: constant ventricular rates (S1S1), short-long-short cycles (S1S2S3-V), and ventricular premature bears (S1); and part 5, shocks delivered synchronously with the last R wave resulting from an atrially paced short- long-short cycle (S1S2S3A). Ventricular tachyarrhythmia was induced 122 times: 2 of 665 shocks in two dogs in part 1, 29 of 786 shocks in nine dogs in part 2, 67 of 734 shocks in 15 dogs in part 3, 24 of 919 shocks in five dogs in part 4, and none in part 5. All ventricular proarrhythmia resulted from shocks delivered during the T wave of a preceding ventricular beat. No episodes of ventricular tachyarrhythmia were induced by atrial shocks synchronized to R waves with the previous RR at intervals above the QT+60 ms interval (absolute interval >320 ms), with one exception, at the QT+ 100 ms interval (absolute interval 360 ms). Conclusions: With transvenous electrode catheters used to deliver atrial shocks, life-threatening ventricular rhythms were induced but were limited to a specific zone defined by the QT interval.
AB - Background: It is recognized that a ventricular vulnerability period exists during which atrial shock delivery may induce a ventricular tachyarrhythmia. This study was designed to define the zone in which the ventricles are vulnerable to induction of ventricular tachyarrhythmia during delivery of atrial shocks in the sterile pericarditis canine model of atrial fibrillation. Methods and Results: Two days after creation of sterile pericarditis, 24 dogs underwent either a four-part or five-part ventricular vulnerability protocol during which atrial shocks were delivered between transvenous catheters, one in the distal coronary sinus and one in the right atrial appendage. The protocol included part 1, shocks during induced atrial fibrillation; parts 2 through 4, shocks delivered synchronously with the last ventricular beat of one of the following three ventricular pacing protocols: constant ventricular rates (S1S1), short-long-short cycles (S1S2S3-V), and ventricular premature bears (S1); and part 5, shocks delivered synchronously with the last R wave resulting from an atrially paced short- long-short cycle (S1S2S3A). Ventricular tachyarrhythmia was induced 122 times: 2 of 665 shocks in two dogs in part 1, 29 of 786 shocks in nine dogs in part 2, 67 of 734 shocks in 15 dogs in part 3, 24 of 919 shocks in five dogs in part 4, and none in part 5. All ventricular proarrhythmia resulted from shocks delivered during the T wave of a preceding ventricular beat. No episodes of ventricular tachyarrhythmia were induced by atrial shocks synchronized to R waves with the previous RR at intervals above the QT+60 ms interval (absolute interval >320 ms), with one exception, at the QT+ 100 ms interval (absolute interval 360 ms). Conclusions: With transvenous electrode catheters used to deliver atrial shocks, life-threatening ventricular rhythms were induced but were limited to a specific zone defined by the QT interval.
KW - Atrium
KW - Defibrillation
KW - Fibrillation
UR - http://www.scopus.com/inward/record.url?scp=0030810775&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030810775&partnerID=8YFLogxK
M3 - Article
C2 - 9286968
AN - SCOPUS:0030810775
VL - 96
SP - 1343
EP - 1350
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 4
ER -