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Der akute Herztod

Bedeutung elektrophysiologischer Stimulationsverfahren
  • G. Breithardt
  • L. Seipel
  • F. Loogen
Conference paper
Part of the Verhandlungen der Deutschen Gesellschaft für Herz- und Kreislaufforschung book series (2849, volume 46)

Zusammenfassung

Klinische und epidemiologische Daten sprechen dafür, daß der akute Herztod in der Mehrzahl der Fälle durch Kammerflimmern zustande kommt (15, 37, 59). Nur in weniger als einem Viertel der außerhalb der Klinik reanimierten Fälle findet sich eine Asystolie (59), wobei eine sekundäre Asystolie nach primärem Kammerflimmern möglich erscheint. Ein totaler AV-Block wird nur selten beobachtet (59). Es ist unbestritten, daß Patienten mit ventrikulären Rhythmusstörungen, insbesondere mit Zwei- und Dreigefäßerkrankung und zusätzlichen Kontraktionsanomalien der linken Herzkammer (Akinesie, Hypokinesie, Aneurysma) besonders gefährdet sind. Hierbei sind die ventrikulären Arrhythmien weniger zum Ausmaß der Koronargefäßverände-rungen als vielmehr zum Vorhandensein von Kontraktionsanomalien korreliert (12–15, 19, 20, 35, 67, 72, 97, 101, 104).

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Literatur

  1. 1.
    Abendroth, R. R., Seipel, L., Breithardt, G.: Reproduzierbarkeit ventrikulärer Echoschläge bei programmierter rechtsventrikulärer Stimulation. Z. Kardiol. 69, 211 (1980).Google Scholar
  2. 2.
    Akhtar, M., Damato, A. N., Batsford, W. P., Ruskin, J. N., Ogunkelu, J. B., Vargas, G.: Demonstration of reentry within the His-Purkinje system in man. Circulation 50, 1150 (1974).PubMedGoogle Scholar
  3. 3.
    Akhtar, M., Damato, A. N., Ruskin, J. N., Ogunkelu, J. B., Reddy, C. P., Leeds, C. J.: Characteristics and coexistence of two forms of ventricular echo phenomena. Amer. Heart J. 92, 174 (1976).PubMedCrossRefGoogle Scholar
  4. 4.
    Akhtar, M., Gilbert, C., Wolf, F. G., Schmidt, D. H.: Reentry within the His-Purkinje system: Elucidation of reentrant circuit utilizing right bundle branch and His bundle recordings. Circulation 58, 295 (1978).PubMedGoogle Scholar
  5. 5.
    Akhtar, M.: Reentry within the His-Purkinje-System. In: Cardiac Arrhythmias: Electrophysiology, diagnosis and management. Ed. by O. S. Narula, Baltimore/London 1979, 397.Google Scholar
  6. 6.
    Akhtar, M., Gilbert, C. J., Wolf, F. G., Schmidt, D. H.: Retrograde conduction in the His-Purkinje system. Analysis of the routes of impulse propagation using His and right bundle branch recordings. Circulation 59, 1252 (1979).PubMedGoogle Scholar
  7. 7.
    Andresen, D., Tietze, U., v. Leitner, E. R., Lehmann, H. U., Thormann, I., Wessel, H. J., Schröder, R.: Spontanvariablilität tachykarder Rhythmusstörungen. Z. Kardiol. 69, 214 (1980).Google Scholar
  8. 8.
    Antoni, H.: Electrophysiological mechanisms underlying pharmacological models of cardiac fibrillation. Naunyn-Schmiede-bergs Arch. exp. Path. Pharmak. 269, 117 (1971).Google Scholar
  9. 9.
    Axelrod, P., Verrier, R., Lown, B., Thompson, P.: Changes invulnerability during recovery from myocardial infarction exposed by R/T pacing. Circulation 46, 11–127 (1972).Google Scholar
  10. 10.
    Axelrod, P. J., Verrier, R. L., Lown, B.: Vulnerability to ventricular fibrillation during acute coronary artery occlusion and release. Amer. J. Cardiol. 36, 776 (1975).PubMedCrossRefGoogle Scholar
  11. 11.
    Benditt, D. G., Pritchett, E. L. C., Wallace, A. G., Gallagher, J. J.: Recurrent ventricular tachycardia in man: evaluation of disopyramide therapy by intracardiac electrical stimulation. Europ. J. Cardiol. 9, 255 (1979).Google Scholar
  12. 12.
    Bethge, K. P., Bethge, H. C., Graf, A., van den Berg, E., Lichtlen, P.: Kammer-Arrhythmien bei chronisch koronarer Herzkrankheit. Analyse anhand des Langzeit-Elektrokardiogrammes und der selektiven Koronaro-graphie bzw. linksventrikulären Angiographie. Z. Kardiol. 66, 1 (1977).PubMedGoogle Scholar
  13. 13.
    Bethge, K.-P., Klein, H., Lichtlen, P.: Koronare Herzerkrankung, Rhythmusstörungen und plötzlicher Herztod. Intern. Welt 4,107 (1979).Google Scholar
  14. 14.
    Bigger, Jr., J. T., Dresdale, R. J., Heissenbuttel, R. H., Weld, F. M., Wit, A. L.: Ventricular arrhythmias in ischemic heart disease: Mechanism, prevalence, significance, and management. Progr. Cardiovasc. Dis. 14, 255 (1977).CrossRefGoogle Scholar
  15. 15.
    Breithardt, G., Seipel, L., Loogen, F.: Häufigkeit, Prognose und Therapie von Herzrhythmusstörungen bei koronarer Herzkrankheit. Z. Kardiol. 67, 1 (1978).PubMedGoogle Scholar
  16. 16.
    Breithardt, G., Seipel, L., Haerten, K., Abendroth, R.-R., Loogen, F.: Effektivitätskontrolle der antiarrhythmischen Therapie bei Patienten mit chro-nisch-rezidivierenden ventrikulären Tachykardien mittels elektrophysiologischer Stimulationsverfahren. Z. Kardiol. 68, 725 (1979).PubMedGoogle Scholar
  17. 17.
    Breithardt, G., Seipel, L., Abendroth, R. R., Loogen, F.: Serial electrophysiological testing of antiarrhythmic drug efficacy in patients with recurrent ventricular tachycardia. Europ. Heart J. 1, 11 (1980).Google Scholar
  18. 18.
    Burgess, M.J., Williams, D., Ershler, P.: Influence of test site on ventricular fibrillation threshold. Amer. Heart. J. 94, 55 (1977).PubMedCrossRefGoogle Scholar
  19. 19.
    Calvert, A., Lown, B., Gorlin, R.: Ventricular premature beats and anatomically defined coronary heart disease. Amer. J. Cordiol. 39, 627 (1977).CrossRefGoogle Scholar
  20. 20.
    Califf R. M., Burks, J. M., Behar, V. S., Margolis, J. R., Wagner, G. S: Relationship among ventricular arrhythmias, coronary artery disease and angiographic and electrocardiographic indicators of myocardial fibrosis. Circulation 57, 725 (1978).PubMedGoogle Scholar
  21. 21.
    Castillo, C. A., Castellanos, A., Jr.: Retrograde activation of the His bundle during intermittent paired ventricular stimulation in the human heart. Circulation 47, 1079 (1970).Google Scholar
  22. 22.
    Castillo, C., Castellanos, A., Jr.: Retrograde activation of His bundle in the human heart. Am. J. Cardiol. 27, 264 (1971).PubMedCrossRefGoogle Scholar
  23. 23.
    Cats, V. M., Lie, K. L., van Capelle, F. J. L., Dürrer, D.: Limitations of 24 hour ambulatory electrocardiographic recording in predicting coronary events after acute myocardial infarction. Amer. J. Cardiol. 44, 1257 (1979).PubMedCrossRefGoogle Scholar
  24. 24.
    Cobb, L. A., Baum, R. S., Alvarez III, H, Schaffer, W. A.: Resuscitation from out-of-hospital ventricular fibrillation: 4 years follow-up. Circulation 52, Suppl. III–223 (1975).Google Scholar
  25. 25.
    Cooper, M. J., Abinader, E. G.: Atropine-induced ventricular fibrillation: Case report and review of the literature. Amer. Heart. J. 97, 225 (1979).PubMedCrossRefGoogle Scholar
  26. 26.
    Cranefield, P. F., Aronson, R. S.: Initiation of sustained rhythmic activity by single propagated action potentials in canine cardiac Purkinje fibers exposed to sodium free solution or to ouabain. Circulation Res. 34, 477 (1974).PubMedGoogle Scholar
  27. 27.
    Cranefield, P. F., Wit, A. L.: Sustained rhythmicity in cardiac fibers with slow response activity triggered by propagated action potentials. Circulation 50, 97 (1974).Google Scholar
  28. 28.
    Damato, A. N., Lau, S. H, Bobb, G. A.: Studies on ventriculoatrial conduction and the reentry phenomenon. Circulation 41, 423 (1970).PubMedGoogle Scholar
  29. 29.
    Denes, P., Wu, D., Dhingra, R., Pietras, R. J., Rosen, K. M.: The effect of cycle length on cardiac refractory periods in man. Circulation 49, 32 (1974).PubMedGoogle Scholar
  30. 30.
    Denes, P., Wu, D., Dhingra, R. C., Amat-Y-Leon, F, Wyndham, C., Mautner, R. K., Rosen, K.M.: Electrophysiological studies in patients with chronic recurrent ventricular tachycardia. Circulation 54, 229 (1976).PubMedGoogle Scholar
  31. 31.
    Dense, P., Wu, D., Wyndham, Ch., Kehoe, R., Highley, R., Rosen, K.: Chronic elektrophysiological study of paroxysmal ventricular tachycarida. Circulation 58, suppl. II–155 (1978).Google Scholar
  32. 32.
    Desilva, R. A., Verrier, R. L., Lown, B.: Protective effect of the vagotonic action of morphine sulphate on ventricular vulnerability. Cardiovasc. Res. 12, 167 (1978).CrossRefGoogle Scholar
  33. 33.
    Dhatt, M. S., Akhtar, M., Ready, C. R., Gomes, J. A. C., Lau, S. H., Carada, A. R., Damato, A.N.: Modification and abolition of re-entry within the His-Purkinje system in man by diphenylhydantoin. Circulation 56, 720 (1977).PubMedGoogle Scholar
  34. 34.
    Drew, T. M., Josephson, M. E., Horowitz, L. N.: The significance of the repetitive ventricular response to programmed ventricular stimulation. Clin. Res. 25, 218 A (1977).Google Scholar
  35. 35.
    van Durme, J.-P., Pannier, R. H.: Prognostic significance of ventricular dysrhythmias 1 year after myocardial infarction. Amer. J. Cardiol. 37, 178 (abstr.) (1976).CrossRefGoogle Scholar
  36. 36.
    Eberle, F., Schmitt, C. G., Köhler, F.: Kammerflimmern während der Funktionsprüfung eines Demand-Schrittmachers. Erhöhtes Risiko durch Schenkelblock, ventrikuläre Extrasystolen, Digitalisintoxikation und Hypokaliämie. Herz/Kreislauf 11, 585 (1979).Google Scholar
  37. 37.
    Effert, S., Erbel, R., Meyer, J.: Definition und Problematik des akuten Herztodes. Verh. Dtsch. Ges. Kreislauf-forschg. 1980, im Druck.Google Scholar
  38. 38.
    El-Sherif, N., Lazzara, R., Hope, R. R., Scherlag, B. J.: Re-entrant arrhythmias in the late myocardial infarction period 3. Manifest and concealed extrasystolic grouping. Circulation 56, 225 (1977).PubMedGoogle Scholar
  39. 39.
    Engel, T. R., Mendizabal, R., Meister, S. G., Bentivoglio, L. G., Franki, W. S.: Testing for ventricular tachycardia with programmed extra-systoles in sinus rhythm. Circulation 52, suppl. II–178 (1975).Google Scholar
  40. 40.
    Farshidi, A., Michelson, E. L., Greenspan, A. M., Spielman, S. R., Kastor, J. A., Horrowitz, L. N., Josephson, M. E.: Repetitive responses to ventricular extrastimuli-Incidence, mechanism and significance. Amer. J. Cardiol. 43, 390 (abstr.) (1979).Google Scholar
  41. 41.
    Fisher, J. D., Cohen, H. L., Mehra, R., Altschuler, H., Escher, D. J. W., Furman, S.: Cardiac pacing and pacemakers. II. Serial electrophysiologic-pharmacologic testing for control of recurrent tachyarrhythmias. Amer. Heart. J. 93, 658 (1977).PubMedCrossRefGoogle Scholar
  42. 42.
    Fisher, J. D.: Ventricular tachycardia-practical and provocative electrophysiology (editorial). Circulation 58, 1000 (1978).PubMedGoogle Scholar
  43. 43.
    Fleischmann, D. W., Pop, T., DeBakker, J. M. T.: Evidence for re-entry within the His-Purkinje system in man during extrasystolic stimulation of the right ventricle: Macro-versus micro-re-entry. In: Re-entrant arrhythmias, p. 256. Editor: H. E. Kulbertus. MTP Press, Lancaster, 1977.Google Scholar
  44. 44.
    Fleischmann, D. W., Pop, T.: Assessment of refractoriness of the human Purkinje system. Cardiovasc. Res. 12, 681 (1978).PubMedCrossRefGoogle Scholar
  45. 45.
    Fleischmann, D., Pop, T., Marschall, H., Wiesener, M., DeBakker, J. M. T., Erbel, R., Effert, S.: Über die Vulnerabilität der menschlichen Kammer bei vorzeitiger Reizung. Z. Kardiol. 68, 253 (1979).Google Scholar
  46. 46.
    Fleischmann, D. W., Pop, T., Marschall, H. U., Wiesener, M. U., DeBakker, J. M. T., Erbel, R.: Über die Vulnerabilität der menschlichen Herzkammer bei vorzeitiger Stimulation. Elektrophysiologische Befunde. Z. Kardiol. 68, 419 (1979).PubMedGoogle Scholar
  47. 47.
    Fleischmann, D. W., Pop, T., Marschall, H. U., DeBakker, J. M. T.: Rate and rhythm dependent vulnerability of the human ventricular myocardium. Basic Res. Cardiol. 74, 203 (1979).PubMedCrossRefGoogle Scholar
  48. 48.
    Gallagher, J. J., Damato, A. N., Varghese, P. J, Lau, S. H.: Localization of an area of maximum refractoriness or “gate” in the ventricular specialized conduction system in man. Amer. Heart. J. 84, 310 (1972).PubMedCrossRefGoogle Scholar
  49. 49.
    Greene, H. L., Reid, R. R., Schaeffer, A. H.: The repetitive ventricular response in man. A predictor of sudden death. New Engl. J. Med. 299, 729 (1978).PubMedCrossRefGoogle Scholar
  50. 50.
    Greene, H. L., Reid, P. R., Schaeffer, A. H: Induction of intraventricular reentry in man by programmed pacing techniques. Circulation 60, suppl. II–191 (1979).Google Scholar
  51. 51.
    Greene, H. L., Reid, P. R., Schaeffer, A. H: Mechanism of the repetitive ventricular response in man. Am. J. Cardiol. 45, 227 (1980).PubMedCrossRefGoogle Scholar
  52. 52.
    Guerot, C. L., Valere, P. E., Castillo-Fenoy, A., Tricot, R.: Tachycardie par ré-entrée de branche à branche. Arch. Mal. Cœur, 67, 1 (1974).PubMedGoogle Scholar
  53. 53.
    Guss, S. B. Kastor, J. A., Josephson, M. E., Scharf, D. L.: Human ventricular refractoriness. Effects of cycle length, pacing site and atropine. Circulation 53, 450 (1976).PubMedGoogle Scholar
  54. 54.
    Han, J., Garcia de Jalon, P. D., Moe, G. K.: Fibrillation threshold of premature ventricular responses. Circulation Res. 18, 18 (1966).PubMedGoogle Scholar
  55. 55.
    Han, J.: Ventricular vulnerability during acute coronary occlusion. Amer. J. Cardiol. 24, 857 (1969).PubMedCrossRefGoogle Scholar
  56. 56.
    Herling, I. M., Horowitz, L. N., Mitnick, G. S., Kastor, J. A., Josephson, M. E.: Is suppression of ventricular ectopic activity a marker for successful therapy of ventricular tachycardia? Circulation 60, suppl. II–255 (1979).Google Scholar
  57. 57.
    Horowitz, L. N, Spear, J. F., Josephson, M. E., Kastor, J. A., MacVaugh, H., Moore, E. N: Ventricular fibrillation threshold in man. Amer. J. Cardiol. 39, 274 (abstr.) (1977).Google Scholar
  58. 58.
    Horowitz, L. N, Josephson, M. E., Farshidi, A., Spielman, S. R., Michelson, E. L., Greenspan, A. M.: Recurrent sustained ventricular tachycardia. 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens. Circulation 58, 986 (1978).PubMedGoogle Scholar
  59. 59.
    Iseri, L., Humphrey, S. B., Siner, E. J.: Prehospital brady-asystolic cardiac arrest. Ann. Intern. Med. 88, 741 (1978).PubMedGoogle Scholar
  60. 60.
    Jenzer, H., Lohrbauer, L., Lown, B.: Response to single threshold stimuli following acute myocardial infarction. Proc. Soc. Exp. Biol. Med. 141, 606 (1972).PubMedGoogle Scholar
  61. 61.
    Josephson, M. E., Kastor, J. A.: His-Purkinje Conduction during retrograde stress. J. Clin. Investigation 61, 171 (1978).CrossRefGoogle Scholar
  62. 62.
    Josephson, M. E., Horowitz, L. N., Farshidi, A., Kastor, J. A.: Recurrent sustained ventricular tachycardia. I. Mechanisms. Circulation 57, 431 (1978).PubMedGoogle Scholar
  63. 63.
    Josephson, M. E., Horowitz, L. N., Farshidi, A., Spear, J. F., Kastor, J. A., Moore, E. N.: Recurrent sustained ventricular tachycardia. 2. Endocardial mapping. Qrculation 57, 440 (1978).Google Scholar
  64. 64.
    Josephson, M. E., Horowitz, L. N., Greenspan, A. M., Spielman, S. R., Kastor, J. A.: Electrophysiologic findings in patients suffering cardiac arrest. Amer. J. Cardiol. 45, 406 (abstr.) (1980).CrossRefGoogle Scholar
  65. 65.
    Kastor, J. A., Josephson, M. E.: Slow conduction-a constant feature of human His-Purkinje function. Am. J. Cardiol. 37, 147 (1976).CrossRefGoogle Scholar
  66. 66.
    Kehoe, R., Bauernfeind, R. A., Wyndham, Ch. R. C., Meyers, S., Talano, J., Rosen, K. M.: Inducible ventricular tachycardia in patients without of hospital ventricular fibrillation. Amer. J. Cardiol. 45, 444 (abstr.) (1980).CrossRefGoogle Scholar
  67. 67.
    Klein, M. D.: Asynergy and ventricular premature beats (Edit.) Chest 66, 346 (1974).PubMedCrossRefGoogle Scholar
  68. 68.
    Klein, G. J., Ideker, R. E., Smith, W. M., Harrison, L. A., Kaseli, J., Wallace, A. G., Gallagher, J. J.: Epicardial mapping of the onset of ventricular tachycardia initiated by programmed stimulation in the canine heart with chronic infarction. Circulation 60, 1375 (1979).PubMedGoogle Scholar
  69. 69.
    Koch, R., Wiessmann, B.: Kammerflimmern durch Herzschrittmacher. Z. Kreislaufforschg. 60, 842 (1971).Google Scholar
  70. 70.
    Lazzara, R., El-Sherif, N., Befeler, B., Scherlag, B. J.: Regional refractoriness within the ventricular conduction system. Circ. Res. 39, 254 (1976).PubMedGoogle Scholar
  71. 71.
    Lemberg, L., Castellanos, A., Jr., Arcebal, A. G, Berkovits, B. V., Hernandez-Pierretti, O.: Systolic and diastolic pacemaker induced repetitive firing in the human heart. Analysis of 23 cases. J. Electrocardiol. 2, 353 (1979).CrossRefGoogle Scholar
  72. 72.
    Lichtlen, R. R., Bethge, K. P.: Beziehungen zwischen malignen ventrikulären Rhythmusstörungen, linksventrikulärer Funktion und plötzlichem Koronartod. Verh. Dtsch. Ges. Kreislaufforschg. 1980.Google Scholar
  73. 73.
    Lown, B., Kleiger, R., Williams, J.: Cardioversion and digitalis drugs: changed threshold to electric shock in digitalized animals. Circ. Res. 17, 519 (1965).PubMedGoogle Scholar
  74. 74.
    Lown, B.: Electrical stimulation to estimate the degree of digitalization. II. Experimental studies. Am. J. Cardiol. 22, 251 (1968).PubMedCrossRefGoogle Scholar
  75. 75.
    Lown, B., Verrier, R. L.: Neural activity and ventricular fibrillation. N. Engl. J. Med. 294, 1165 (1976).PubMedCrossRefGoogle Scholar
  76. 76.
    Lown, B., Graboys, T. B.: Management of patients with malignant ventricular arrhythmias. Am. J. Cardiol. 39, 910 (1977).PubMedCrossRefGoogle Scholar
  77. 77.
    Lown, B., Verrier, R. L., Blatt, C. M.: Precordial mechanical stimulation for exposing instability in the ischemic heart. Amer. J. Cardiol. 42, 425 (1978).PubMedCrossRefGoogle Scholar
  78. 78.
    Lown, B.: Sudden cardiac death: the major challenge confronting contemporary cardiology. Amer. J. Cardiol. 43, 313 (1979).PubMedCrossRefGoogle Scholar
  79. 79.
    Lyons, C. J., Burgess, M. J.: Demonstration of re-entry within the canine specialized conduction system. Am. Heart. J. 97, 595 (1980).Google Scholar
  80. 80.
    Mason, J. W., Winkle, R. A.: Electrode catheter arrhythmia induction in the selection and assessment of antiarrhythmic drug therapy for recurrent ventricular tachycardia. Circulation 58, 971 (1978).PubMedGoogle Scholar
  81. 81.
    Mason, J. W.: Repetitive beating after single ventricular extrastimuli: incidence and prognostic significance in patients with recurrent ventricular tachycardia. Amer. J. Cardiol. 45, 407 (1980).CrossRefGoogle Scholar
  82. 82.
    Matta, R. J., Verrier, R. L., Lown, B.: The repetitive extrasystole as an index of vulnerability to ventricular fibrillation. Am. J. Physiol. 230, 1469 (1976).PubMedGoogle Scholar
  83. 83.
    Mautner, R., Denes, P., Dhingra, R., Wu, D., Amat-y-Leon, F, Wyndham, C. R. C., Rosen, K.: Inability to reproduce chronic recurrent ventricular tachycardia in the catherization laboratory. Circulation 52, suppl. II–137 (1975).Google Scholar
  84. 84.
    Merx, W., Han, J., Yoon, M. S.: Effects of unipolar cathodal and bipolar stimulation on vulnerability of ischemic ventricles to fibrillation. Amer. J. Cardiol. 35, 37 (1975).PubMedCrossRefGoogle Scholar
  85. 85.
    Michelson, E. L., Spear, J. F., Moore, E. N.: Initiation of sustained ventricular tachyarrhythmias in a model of chronic infarction: importance of the site of stimulation. Amer. J. Cardiol. 45, 494 (1980).CrossRefGoogle Scholar
  86. 86.
    Moe, G. K, Méndez, C., Han, J.: Aberrant A-V impulse propagation in the dog heart: a study of functional bundle branch block. Circ. Res. 16, 261 (1965).PubMedGoogle Scholar
  87. 87.
    Moore, E. N.: Microelectrode studies on retrograde concealment of multiple premature ventricular responses. Circ. Res. 20, 88 (1967).PubMedGoogle Scholar
  88. 88.
    Moore, E. N., Spear, J. F.: Ventricular fibrillation threshold. Its physiological and pharmacological importance. Arch. Intern. Med. 135, 446 (1975).PubMedCrossRefGoogle Scholar
  89. 89.
    Morgenroth, J., Michelson, E. L., Horowitz, L. N., Josephson, M. E., Pearlman, A. S., Dunkman, W. B.: Limitations of routine long-term ambulatory electrocardiographic monitoring to assess ventricular ectopic frequency. Circulation 58, 408 (1978).Google Scholar
  90. 90.
    Myerburg, R. J, Sung, R. J., Conde, C., Mallon, S. M., Castellanos, A.: Intracardiac electrophysiologic studies in patients resuscitated from unexpected cardiac arrest outside the hospital. Amer. J. Cardiol. 39, 275 (abstr.) (1977).Google Scholar
  91. 91.
    Preston, T. A.: Anodal stimulation as a cause of pacemaker-induced ventricular fibrillation. Am. Heart. J. 86, 366 (1973).PubMedCrossRefGoogle Scholar
  92. 92.
    Reddy, C. P., Gettes, L. S.: Use of isoproterenol as an aid to electric induction of chronic recurrent ventricular tachycardia. Am. J. Cardiology 44, 705 (1979).CrossRefGoogle Scholar
  93. 93.
    Reddy, C. P., Harris, B.: Gap phenomenon in “the right and left bundle branch systems” during retrograde conduction in man. Amer. Heart. J. 97, 216 (1979).PubMedCrossRefGoogle Scholar
  94. 94.
    Rinkenberger, R. L., Prystowsky, E. N., Jackman, W. M., Heger, J. J., Zipes, D. P.: Premature ventricular stimulation during sinus rhythm or atrial pacing has low sensitivity in identifying patients with recurrent ventricular tachycardia or ventricular fibrillation. Clin. Res. 27, 619A (abstr.) (1979).Google Scholar
  95. 95.
    Ruskin, J. N., Garan, H.: Electrophysiologic observations and serial drug testing in survivors of prehospital cardiac arrest. Circulation 60, suppl. II–22 (abstr.) (1979).Google Scholar
  96. 96.
    Ruskin, J. N., Garan, H.: Repetitive ventricular responses in patients with life-threatening ventricular arrhythmias. Amer. J. Cardiol. 45, 406 (abstr.) (1980).CrossRefGoogle Scholar
  97. 97.
    Samek, L., Kirste, D., Roskamm, H., Stürzenhofecker, P., Prokoph, J.: Herzrhythmusstörungen nach Herzinfarkt. Beziehungen zur Bewegungstherapie, zu funktionellen und morphologischen Variablen. Herz/Kreislauf 9, 641 (1977).Google Scholar
  98. 98.
    Schaeffer, A. H., Greene, H. L., Reid, P. R.: Suppression of the repetitive ventricular response: An index of long-term antiarrhythmic effectiveness of aprindine for ventricular tachycardia in man. Amer. J. Cardiol. 42, 1007 (1978).PubMedCrossRefGoogle Scholar
  99. 99.
    Scheinman, M. M.: Induction of ventricular tachycardia: a promising new technique or clinical electrophysiology gone awry? (editorial). Circulation 58, 998 (1978).PubMedGoogle Scholar
  100. 100.
    Schuilenburg, R. M., Durrer, D.: Ventricular echo beats in the human heart elicited by induced ventricular premature beats. Circulation 40, 337 (1969).Google Scholar
  101. 101.
    Schulze, R. A., Jr., Strauss, H. W., Pitt, B.: Sudden death in the year following myocardial infarction. Am. J. Med. 62, 192 (1977).PubMedCrossRefGoogle Scholar
  102. 102.
    Seipel, L., Bub, E., Loogen, F.: Ventricular fibrillation induced by a unipolar implanted pacemaker (cathodal stimulation). Am. Heart. J. 92, 810 (1976).PubMedCrossRefGoogle Scholar
  103. 103.
    Seipel, L., Breithardt, G.: Electrophysiological effects of mexiletine in man: influence on stimulus-induced ventricular arrhythmias. In: Management of ventricular tachycardia-role of mexiletine, eds. Sandoe, E., Julian, D. G, Bell, J. W., Excerpta Medica Amsterdam, Oxford 1978, p. 219.Google Scholar
  104. 104.
    Sharma, S. D., Ballantyne, F., Goldstein, S.: The relationship of ventricular asynergy in coronary artery disease to ventricular premature beats. Chest 66, 358 (1974).PubMedCrossRefGoogle Scholar
  105. 105.
    Sharma, B., Hodges, M., Asinger, R. W., Francis, G.: Lack of effect of associated myocardial infarction on long-term survival of out-of-hospital ventricular fibrillation. Amer. J. Cardiol. 45, 443 (1980) (abstr.).CrossRefGoogle Scholar
  106. 106.
    Shumway, N. E., Johnson, J. A., Stish, R. J.: The study of ventricular fibrillation by threshold determinations. J. Thorac. cardiovasc. Surgery 34, 643 (1957).Google Scholar
  107. 107.
    Spielman, S. R., Michelson, E. L., Horowitz, L. N., Spear, J. F., Moore, E. N.: The limitations of epicardial mapping as a guide to the surgical therapy of ventricular tachycardia. Circulation 57, 666 (1978).PubMedGoogle Scholar
  108. 108.
    Spielman, S. R., Farshidi, A., Horowitz, L. N., Josephson, M. E.: Ventricular fibrillation during programmed ventricular stimulation: incidence and clinical implications. Amer. J. Cardiol. 42, 913 (1978).PubMedCrossRefGoogle Scholar
  109. 109.
    Spurrell, R. A. J., Sowton, E., Deuchar, D. C.: Ventricular tachycardia in 4 patients evaluated by programmed electrical stimulation of heart and treated in 2 patients by surgical division of anterior radiation of left bundle-branch. Brit. Heart. J. 35, 1014 (1973).PubMedCrossRefGoogle Scholar
  110. 110.
    Spurrell, R. A. J., Yates, A., Thorburn, C. W., Lawton, G. E., Deuchar, D. C: Surgical treatment of ventricular tachycardia after epicardial mapping. Brit. Heart. J. 37, 115 (1975).PubMedCrossRefGoogle Scholar
  111. 111.
    Stein, G., Jungmann, H.: Spontanschwankungen von Rhythmusstörungen bei Infarktrehabilitanden. Herz/Kreislauf 11, 346 (1979).Google Scholar
  112. 112.
    Steinbeck, G., Manz, M., Lüderitz, B.: Möglichkeiten und Risiken der programmierten Ventrikelstimulation bei rezidivierenden Kammertachykardien. Z. Kardiol. 69, 211 (abstr.) (1980).Google Scholar
  113. 113.
    Surawicz, B., Steffens, T.: Cardiac vulnerability. Cardiovasc. Clinics 6, 160 (1974).Google Scholar
  114. 114.
    Thompson, P. L., Lown, B.: Sequential R/T pacing to expose electrical instability in the ischemic ventricle. Clin. Res. 20, 401 (1972).Google Scholar
  115. 115.
    Trautwein, W., Gottstein, U., Dudel, J.: Der Aktionsstrom der Myokardfaser im Sauerstoffmangel. Pflueger’s Archiv 260, 40 (1954).CrossRefGoogle Scholar
  116. 116.
    Vande Pol, Ch. J., Farshidi, A., Spielman, S. R., Greenspan, A. M., Horowitz, L. N., Kastor, J. A., Josephson, M. E.: Sensitivity and specificity of programmed ventricular stimulation in patients with ventricular tachycardia. Amer. J. Cardiol. 45, 407 (abstr.) (1980).Google Scholar
  117. 117.
    Verrier, R. L., Thompson, P. L., Lown, B.: Ventricular vulnerability during sympathetic stimulation: role of heart rate and blood pressure. Cardiovasc. Res. 8, 602 (1974).PubMedCrossRefGoogle Scholar
  118. 118.
    Verrier, R. L., Calvert, A., Lown, B.: Effect of posterior hypothalamic stimulation on ventricular fibrillation threshold. Amer. J. Physiol. 228, 923 (1975).PubMedGoogle Scholar
  119. 119.
    Wellens, H. J., Schuilenburg, R. M., Durrer, D.: Electrical stimulation of the heart in patients with ventricular tachycardia. Circulation 46, 216 (1972).PubMedGoogle Scholar
  120. 120.
    Wegria, R., Moe, G. K, Wiggers, C. J.: Comparisons of the vulnerable periods and fibrillation threshold of normal and idioventricular beats. Amer. J. Physiol. 133, 651 (1941).Google Scholar
  121. 121.
    Wellens, H. J. J., Lie, K. L, Dürrer, D.: Further observations on ventricular tachycardia as studied by electrical stimulation of the heart. Chronic recurrent ventricular tachycardia and ventricular tachycardia during acute myocardial infarktion. Circulation 49, 647 (1974).PubMedGoogle Scholar
  122. 122.
    Wellens, H. J: Pathophysiology of ventricular tachycardia in man. Arch. Intern. Med. 135, 473 (1975).PubMedCrossRefGoogle Scholar
  123. 123.
    Wellens, H. J. J., Düren, D. R., Lie, K. I.: Observations on mechanism of ventricular tachycardia in man. Circulation 54, 237 (1976).PubMedGoogle Scholar
  124. 124.
    Wellens, H. J. J.: Value and limitations of programmed electrical stimulation of the heart in the study and treatment of tachycardias. Circulation 57, 845 (1978).PubMedGoogle Scholar
  125. 125.
    Wellens, H. J., Bär, F. W., Farré, J., Gorgels, A. P.: Characteristics of patients with ventricular tachycardia initiated by supraventricular stimuli. Circulation 58, suppl. II–154 (abstr.) (1978).Google Scholar
  126. 126.
    Wellens, H. J. J., Bär, F. W., Wiener, L, Farré, J., Ross, D. L., Kersemaker, J.: Ginical relevance of tachycardias induced during programmed cardiac stimulation. Amer. J. Cardiol. 43, 400 (abstr.) (1979).Google Scholar
  127. 127.
    Wick, E., Bell, U., Dengler, H. J.: Die Wirkung von Sparteinsulfat auf mechanisch ausgelöste Extrasystolen beim Menschen. Med. Welt 22, 303 (1971).Google Scholar
  128. 128.
    Wiggers, C. J., Wegria, R.: Ventricular fibrillation due to single, localized induction and condenser shocks applied during the vulnerable phase of ventricular systole. Amer. J. Physiol. 128, 40, 500 (1979).Google Scholar
  129. 129.
    Wiggers, C. J.: The mechanism and nature of ventricular fibrillation. Am. Heart. J. 20, 399 (1940).CrossRefGoogle Scholar
  130. 130.
    Wiggers, J. C., Wegria, R., Pinera, B.: The effects of myocardial ischemia on the fibrillation threshold. Mechanism of spontaneous ventricular fibrillation following coronary occlusion. Amer. J. Physiol. 131, 309 (1940).Google Scholar
  131. 131.
    Williams, D. O., Scherlag, B. J., Hope, R. R., El-Sherif, N., Lazzara, R.: The pathophysiology of malignant ventricular arrhythmias during acute myocardial ischemia. Circulation 50, 1163 (1974).PubMedGoogle Scholar
  132. 132.
    Winkle, R. A.: Antiarrhythmic drug effect mimicked by spontaneous variability of ventricular ectopy. Circulation 57, 1116 (1978).PubMedGoogle Scholar
  133. 133.
    Wit, A. L., Bigger, Jr., J. T.: Possible electrophysiological mechanisms for lethal arrhythmias accompanying myocardial ischemia and infarction. Circulation 52, suppl. III–96 (1975).Google Scholar
  134. 134.
    Wu, D., Wyndham, C. R., Denes, P., Amat-Y-Leon, F., Miller, R. H, Dhingrd, R. C., Rosen, K. M.: Chronic electrophysiological study in patients with recurrent paroxysmal tachycardia: a new method for developping successful oral antiarrhythmic therapy. In: Re-entrant arrhythmias. Mechanisms and treatment, ed. H. E. Kulbertus, MTP 1977, Lancaster, p. 294.Google Scholar
  135. 135.
    Yoon, M. S., Han, J. Fabregas, R. A.: Effect of ventricular aberrancy on fibrillation threshold. Amer. Heart. J. 89, 599 (1975).PubMedCrossRefGoogle Scholar
  136. 136.
    Younossi, K., Rüdiger, H. J., Haap, Kp., Antoni, H.: Untersuchungen über die Flimmerschwelle des isolierten Meerschweinchen-Herzens für Gleichstrom und sinusförmigem Wechselstrom. Basic Res. Cardiol. 68, 551 (1973).PubMedCrossRefGoogle Scholar
  137. 137.
    Zipes, D. P.: Electrophysiological mechanisms involved in ventricular fibrillation. Circulation 52, suppl. III–120 (1975).Google Scholar
  138. 138.
    Zipes, D. P., Foster, P. R., Troup, P. J., Pedersen, D. H.: Atrial induction of ventricular tachycardia: Reentry versus triggered automaticity. Am. J. Cardiology 44, 1 (1979).CrossRefGoogle Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag GmbH & Co. KG · Darmstadt 1980

Authors and Affiliations

  • G. Breithardt
    • 1
    • 2
  • L. Seipel
    • 1
  • F. Loogen
    • 1
  1. 1.Med. Klinik und Poliklinik, Klinik BUniversität DüsseldorfDeutschland
  2. 2.Med. Klinik und Poliklinik, Klinik BUniversität DüsseldorfDüsseldorfDeutschland

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