Skip to main content

The Value of Programmed Electrical Stimulation in Triggered Activity-Induced Arrhythmias

  • Chapter
Lethal Arrhythmias Resulting from Myocardial Ischemia and Infarction

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 94))

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].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 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.

    PubMed  CAS  Google Scholar 

  2. Brugada, P. and Wellens, HJ.J. 1984. The role of triggered activity in clinical ventricular arrhythmias. PACE 7:260–271.

    Article  PubMed  CAS  Google Scholar 

  3. Rosen, M.R. 1986. Is the response to programmed electrical stimulation diagnostic for mechanism of arrhythmias? Circulation 73 (Suppl. II):18–27.

    Google Scholar 

  4. 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.

    Google Scholar 

  5. Cranefield, P.F. 1977. Action potentials, afterpotentials and arrhythmias. Circ. Res. 41:415–423.

    PubMed  CAS  Google Scholar 

  6. 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.

    Article  PubMed  CAS  Google Scholar 

  7. 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.

    Article  CAS  Google Scholar 

  8. 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.

    Article  PubMed  CAS  Google Scholar 

  9. 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.

    PubMed  CAS  Google Scholar 

  10. 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.

    Article  PubMed  CAS  Google Scholar 

  11. 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.

    Google Scholar 

  12. 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.

    Article  CAS  Google Scholar 

  13. 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.

    Article  PubMed  CAS  Google Scholar 

  14. 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.

    Google Scholar 

  15. 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.

    Article  PubMed  CAS  Google Scholar 

  16. Le Marec, H., Spinelli, W., and Rosen M.R. 1986. The effects of doxorubicin on ventricular tachycardia. Circulation 74, 881–889.

    Article  Google Scholar 

  17. Borgers, M., de Clerck, F., van Reempts, J., et al. 1984. Selective blockade of cellular Ca-overload by flunarizine. Int. J. Angiol. D25–31.

    Google Scholar 

  18. 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.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Kluwer Academic Publishers, Boston/Dordrecht/London

About this chapter

Cite this chapter

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

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-1649-7_20

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8916-6

  • Online ISBN: 978-1-4613-1649-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics