Abstract
Triggered activity induced by delayed afterdepolarizations has been investigated extensively in tissues isolated from different sites in the heart and from different species. In spite of this we still do not know the clinical relevance of this arrhythmogenic mechanism. An answer to this question is important because the ability to identify mechanisms in the clinical situation can improve our understanding of pathophysiology and provide new treatments. Presently, different methods are used to discriminate among mechanisms of arrhythmias, including electrical stimulation [1], antiarrhythmic drugs, and recording of monophasic action potentials. Unfortunately no method has proven to be sufficiently sensitive or specific [2, 3].
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References
Wellens, H.J.J. 1978. Value and limitations of programmed electrical stimulation of the heart in the study and treatment of tachycardias. Circulation 57:845–853.
Brugada, P. and Wellens, HJ.J. 1984. The role of triggered activity in clinical ventricular arrhythmias. PACE 7:260–271.
Rosen, M.R. 1986. Is the response to programmed electrical stimulation diagnostic for mechanism of arrhythmias? Circulation 73 (Suppl. II):18–27.
Le Marec, H., Dangman, K.H., Danilo, P., and Rosen, M.R. 1985. An evaluation of automaticity and triggered activity in the canine heart one to four days after myocardial infarction. Circulation 77:1224–1236.
Cranefield, P.F. 1977. Action potentials, afterpotentials and arrhythmias. Circ. Res. 41:415–423.
Gorgels, A.P.M., de Wit, B., Beekman, H.D.M., et al. 1986. Effect of different modes of stimulation on the morphology of the first QRS-complex following pacing during digitalis induced ventricular tachycardia. PACE 9:842–859.
Gorgels, A.P.M., Beekman, H.D.M., Brugada, P., et al. 1983. Extrastimulus related shortening of the first postpacing interval in difitalis induced ventricular tachycardia. J. Am. Coll. Card. 1:840–857.
Gorgels, A.P.M., de Wit, B., Beekman, H.D.M., et al. 1987. Triggered activity induced by pacing during digitalis intoxication. Observations during programmed electrical stimulation in the conscious dog with chronic complete atrioventricular block. PACE 10:1309–1321.
Ferrier, G.R., Saunders, J.H., and Mendez, C. 1973. A cellular mechanism for the generation of ventricular arrhythmias by acetylstrophantidin. Circ.Res. 32:600–609.
Moak, J.P. and Rosen, M.R. 1984. Induction and termination of triggered activity by pacing in isolated canine Purkinje fibers. Circulation 69:149–162.
Rosen, M.R., and Reder, R.F. 1984. Does triggered activity have a role in the genesis of cardiac arrhythmias? Ann. Int. Med. 94:794–801.
Dangman, K.H. and Hoffman, B.F. 1983. Studies on overdrive stimulation of canine Purkinje fiber. Maximal diastolic potential as a determinant of the response. J. Am. Coll. Card. 2:1183–1179.
Johnson, N., Danilo, P., Jr., Wit, A.L., and Rosen, M.R. 1986. Characteristics of initation and termination of catecholamine induced triggered activity in atrial fibers of the coronary sinus. Circulation 74:1168–1179.
Waldo, A.L., Olshansky, B., Okumura, K., and Henthorn, R.W. 1987. Current perspective on entrainment of tachyarrhythmias, in Cardiac Arrhythmias: Where to Go from Here P. Brugada and H.J.J. Wellens, eds., pp. 171–189, Mount Kisco, NY, Futural Publishing Co.
Almendral, J.M., Stamato, J.M., Rosenthal, M.E., et al. 1986. Resetting response patterns during sustained ventricular tachycardia: relationship to the excitable gap. Circulation 74, 722–730.
Le Marec, H., Spinelli, W., and Rosen M.R. 1986. The effects of doxorubicin on ventricular tachycardia. Circulation 74, 881–889.
Borgers, M., de Clerck, F., van Reempts, J., et al. 1984. Selective blockade of cellular Ca-overload by flunarizine. Int. J. Angiol. D25–31.
Jonkman, F.A.M., Boddeke, H.W., and van Zwieten, P.A. 1986. Protective activity of calcium entry blockers against ouabain intoxication in anesthetized guinea pigs. J. Cardiovasc. Pharmacol 8:1009–1013.
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© 1989 Kluwer Academic Publishers, Boston/Dordrecht/London
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Gorgels, A.P.M., Vos, M.A., Brugada, P., Wellens, H.J.J. (1989). The Value of Programmed Electrical Stimulation in Triggered Activity-Induced Arrhythmias. In: Rosen, M.R., Palti, Y. (eds) Lethal Arrhythmias Resulting from Myocardial Ischemia and Infarction. Developments in Cardiovascular Medicine, vol 94. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1649-7_20
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DOI: https://doi.org/10.1007/978-1-4613-1649-7_20
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