Correlation relationships of the reentrant ventricular tachycardia circuit
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Supporting information
Author(s)
Type
Journal Article
Abstract
INTRODUCTION: A quantitative analysis of the components of reentrant ventricular tachycardia (VT) circuitry could improve understanding of its onset and perpetuation. METHOD: In 19 canine experiments, the left anterior descending coronary artery was ligated to generate a subepicardial infarct. The border zone resided at the epicardial surface of the anterior left ventricle and was mapped 3-5 days postinfarction with a 196-312 bipolar multielectrode array. Monomorphic VT was inducible by extrastimulation. Activation maps revealed an epicardial double-loop reentrant circuit and isthmus, causing VT. Several circuit parameters were analyzed: the coupling interval for VT induction, VT cycle length, the lateral isthmus boundary (LIB) lengths, and isthmus width and angle. RESULTS: The extrastimulus interval for VT induction and the VT cycle length were strongly correlated (p < 0.001). Both the extrastimulus interval and VT cycle length were correlated to the shortest LIB (p < 0.005). A derivation was developed to suggest that when conduction block at the shorter LIB is functional, the VT cycle length may depend on the local refractory period and the delay from wavefront pivot around the LIB. Isthmus width and angle were uncorrelated to other parameters. CONCLUSIONS: The shorter LIB is correlated to VT cycle length, hence its circuit loop may drive reentrant VT. The extrastimulation interval, VT cycle length, and shorter LIB are intertwined, and may depend upon the local refractory period. Isthmus width and angle are less correlated, perhaps being more related to electrical discontinuity caused by alterations in infarct shape at depth.
Date Issued
2023-11-01
Date Acceptance
2023-08-12
Citation
Computer Methods and Programs in Biomedicine, 2023, 241
ISSN
0169-2607
Publisher
Elsevier
Journal / Book Title
Computer Methods and Programs in Biomedicine
Volume
241
Copyright Statement
© 2023 Elsevier B.V. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/37597351
PII: S0169-2607(23)00430-3
Subjects
Animals
Coronary Vessels
Dogs
Electricity
Heart Ventricles
Tachycardia, Ventricular
Activation mapping
Isthmus
Reentrant circuit
Sinus rhythm
Ventricular tachycardia
Publication Status
Published
Coverage Spatial
Ireland
Article Number
107764
Date Publish Online
2023-08-13