Circulation, Vol 82, 2185-2189, Copyright © 1990 by American Heart Association
T Konta, K Ikeda, M Yamaki, K Nakamura, K Honma, I Kubota and S Yasui
With the use of epicardial mapping, we investigated the electrical
alternans of the ST segment during acute myocardial ischemia and studied
the difference in ST alternans between dogs with resultant ventricular
fibrillation and those without it. During the 7-minute occlusion of the
left anterior descending coronary artery below its first diagonal branch,
60 epicardial unipolar electrograms were recorded simultaneously at
1-minute intervals by a computerized mapping system. ST alternans was found
in the eight dogs we observed. The amplitude of ST alternans (difference in
the ST segment elevation of two consecutive electrograms) was greater in
dogs with ventricular fibrillation (n = 4) than in those without it (n = 4)
(3.92 +/- 1.24 versus 0.58 +/- 0.49 mV, p less than 0.05). Three of the
four dogs with ventricular fibrillation demonstrated discordant ST
alternans (i.e., adjacent leads were out of phase). Results from the
present study indicate that an increased amplitude and discordance of ST
alternans during acute myocardial ischemia are related to ventricular
fibrillation and act as indicators of time and spatial unevenness of
ventricular repolarization.
ARTICLES
Significance of discordant ST alternans in ventricular fibrillation
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
This article has been cited by other articles:
 |
|
 |
|
  S. Mironov, J. Jalife, and E. G. Tolkacheva Role of Conduction Velocity Restitution and Short-Term Memory in the Development of Action Potential Duration Alternans in Isolated Rabbit Hearts Circulation, July 1, 2008; 118(1): 17 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Hayashi, Y. Shiferaw, D. Sato, M. Nihei, S.-F. Lin, P.-S. Chen, A. Garfinkel, J. N. Weiss, and Z. Qu Dynamic Origin of Spatially Discordant Alternans in Cardiac Tissue Biophys. J., January 15, 2007; 92(2): 448 - 460. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Yuuki, Y. Hosoya, I. Kubota, and M. Yamaki Dynamic and not static change in ventricular repolarization is a substrate of ventricular arrhythmia on chronic ischemic myocardium Cardiovasc Res, September 1, 2004; 63(4): 645 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Nearing and R. L. Verrier Tracking cardiac electrical instability by computing interlead heterogeneity of T-wave morphology J Appl Physiol, December 1, 2003; 95(6): 2265 - 2272. [Abstract] [Full Text]
|
|
|
|
 |
|
 Y.-W. Qian, R. J. Sung, S.-F. Lin, R. Province, and W. T. Clusin Spatial heterogeneity of action potential alternans during global ischemia in the rabbit heart Am J Physiol Heart Circ Physiol, December 1, 2003; 285(6): H2722 - H2733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Walker, X. Wan, G. E. Kirsch, and D. S. Rosenbaum Hysteresis Effect Implicates Calcium Cycling as a Mechanism of Repolarization Alternans Circulation, November 25, 2003; 108(21): 2704 - 2709. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kumar, K. Nguyen, S. Waxman, B. D. Nearing, G. A. Wellenius, S. X. Zhao, and R. L. Verrier Potent antifibrillatory effects of intrapericardial nitroglycerin in the ischemic porcine heart J. Am. Coll. Cardiol., May 21, 2003; 41(10): 1831 - 1837. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L Walker and D. S Rosenbaum Repolarization alternans: implications for the mechanism and prevention of sudden cardiac death Cardiovasc Res, March 1, 2003; 57(3): 599 - 614. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Castro Hevia, F. Dorticos Balea, M. Dorantes Sánchez, R. Zayas Molina, and M. A. Quiñones Pérez Unusual response to the ajmaline test in a patient with Brugada syndrome Europace, January 1, 2003; 5(4): 371 - 373. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Nearing and R. L. Verrier Progressive Increases in Complexity of T-Wave Oscillations Herald Ischemia-Induced Ventricular Fibrillation Circ. Res., October 18, 2002; 91(8): 727 - 732. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Armoundas, G. F. Tomaselli, and H. D. Esperer Pathophysiological basis and clinical application of T-wave alternans J. Am. Coll. Cardiol., July 17, 2002; 40(2): 207 - 217. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. D. Nearing and R. L. Verrier Modified moving average analysis of T-wave alternans to predict ventricular fibrillation with high accuracy J Appl Physiol, February 1, 2002; 92(2): 541 - 549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-W. Qian, W. T Clusin, S.-F. Lin, J. Han, and R. J Sung Spatial Heterogeneity of Calcium Transient Alternans During the Early Phase of Myocardial Ischemia in the Blood-Perfused Rabbit Heart Circulation, October 23, 2001; 104(17): 2082 - 2087. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Kovach, B. D. Nearing, and R. L. Verrier Angerlike behavioral state potentiates myocardial ischemia-induced T-wave alternans in canines J. Am. Coll. Cardiol., May 1, 2001; 37(6): 1719 - 1725. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Christini, K. M. Stein, S. M. Markowitz, S. Mittal, D. J. Slotwiner, M. A. Scheiner, S. Iwai, and B. B. Lerman Nonlinear-dynamical arrhythmia control in humans PNAS, April 18, 2001; (2001) 91553398. [Abstract] [Full Text]
|
|
|
|
|
|
J. M. Pastore and D. S. Rosenbaum Role of Structural Barriers in the Mechanism of Alternans-Induced Reentry Circ. Res., December 8, 2000; 87(12): 1157 - 1163. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Qu, A. Garfinkel, P.-S. Chen, and J. N. Weiss Mechanisms of Discordant Alternans and Induction of Reentry in Simulated Cardiac Tissue Circulation, October 3, 2000; 102(14): 1664 - 1670. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Narayan and J. M. Smith Exploiting rate-related hysteresis in repolarization alternans to improve risk stratification for ventricular tachycardia J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1485 - 1492. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Zaniboni, A. E. Pollard, L. Yang, and K. W. Spitzer Beat-to-beat repolarization variability in ventricular myocytes and its suppression by electrical coupling Am J Physiol Heart Circ Physiol, March 1, 2000; 278(3): H677 - H687. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Narayan, B. D. Lindsay, and J. M. Smith Demonstration of the Proarrhythmic Preconditioning of Single Premature Extrastimuli by Use of the Magnitude, Phase, and Distribution of Repolarization Alternans Circulation, November 2, 1999; 100(18): 1887 - 1893. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Watanabe, M. Yamaki, I. Kubota, H. Tachibana, and H. Tomoike Relation between activation sequence fluctuation and arrhythmogenicity in sodium-channel blockades Am J Physiol Heart Circ Physiol, September 1, 1999; 277(3): H971 - H977. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Tachibana, M. Yamaki, I. Kubota, T. Watanabe, S. Yamauchi, and H. Tomoike Intracoronary Flecainide Induces ST Alternans and Reentrant Arrhythmia on Intact Canine Heart : A Role of 4-Aminopyridine–Sensitive Current Circulation, March 30, 1999; 99(12): 1637 - 1643. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Pastore, S. D. Girouard, K. R. Laurita, F. G. Akar, and D. S. Rosenbaum Mechanism Linking T-Wave Alternans to the Genesis of Cardiac Fibrillation Circulation, March 16, 1999; 99(10): 1385 - 1394. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Tachibana, I. Kubota, M. Yamaki, T. Watanabe, and H. Tomoike Discordant S-T alternans contributes to formation of reentry: a possible mechanism of reperfusion arrhythmia Am J Physiol Heart Circ Physiol, July 1, 1998; 275(1): H116 - H121. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Wu and W. T. Clusin Calcium transient alternans in blood-perfused ischemic hearts: observations with fluorescent indicator Fura Red Am J Physiol Heart Circ Physiol, November 1, 1997; 273(5): H2161 - H2169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Rubenstein and S. L. Lipsius Premature Beats Elicit a Phase Reversal of Mechanoelectrical Alternans in Cat Ventricular Myocytes : A Possible Mechanism for Reentrant Arrhythmias Circulation, January 1, 1995; 91(1): 201 - 214. [Abstract] [Full Text]
|
|
|
|
 |
|
 D. S. Rosenbaum, L. E. Jackson, J. M. Smith, H. Garan, J. N. Ruskin, and R. J. Cohen Electrical Alternans and Vulnerability to Ventricular Arrhythmias N. Engl. J. Med., January 27, 1994; 330(4): 235 - 241. [Abstract] [Full Text]
|
|
|
|
|
|
D. J. Christini, K. M. Stein, S. M. Markowitz, S. Mittal, D. J. Slotwiner, M. A. Scheiner, S. Iwai, and B. B. Lerman Nonlinear-dynamical arrhythmia control in humans PNAS, May 8, 2001; 98(10): 5827 - 5832. [Abstract] [Full Text] [PDF]
|
|