Is the Ventricular Effective Refractory Period Different When Determined by Incremental Versus Decremental Scanning?: The Effect of Pacing Cycle Length, d-Sotalol, and Levcromakalim

In tbe clinical setting, the ventricular effective refractory period (VERP) is determined by an 8‐beat drive train (S1S1), followed by a premature stimulus (S2), which is decremented in subsequent drive trains until capture is lost. Variation in intertrain pauses and capturing extra stimuli disturb...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 1994-11, Vol.17 (11), p.2084-2089
Main Authors: LEERSSEN, HENDRIK M., VOS, MARC A., den DULK, KAREL, van der ZANDE, JOLANDA, WELLENS, HEIN J.
Format: Article
Language:English
Subjects:
Animals
Anti-Arrhythmia Agents - pharmacology
Benzopyrans - pharmacology
Cardiac Pacing, Artificial
Cromakalim
decremental scanning
Dogs
effect of medication on ventricular effective refractory period
Electrocardiography
Female
incremental scanning
Male
Pyrroles - pharmacology
Refractory Period, Electrophysiological - drug effects
Sotalol - pharmacology
ventricular effective refractory period
Ventricular Function - drug effects
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Summary:In tbe clinical setting, the ventricular effective refractory period (VERP) is determined by an 8‐beat drive train (S1S1), followed by a premature stimulus (S2), which is decremented in subsequent drive trains until capture is lost. Variation in intertrain pauses and capturing extra stimuli disturb steady‐state conditions and reduce reproducibility of values found for the VERP. To increase reproducibility, a protocol without intertrain pause and incremental scanning (IS) of S2 was developed. In anesthetized dogs with chronic AV block, determination of the VERP using IS and decremental scanning (DS) without intertrain pause was compared at 800 and 350 msec pacing cycle length (PCL). The measurements were repeated after the administration of d‐sotalol to lengthen the VERP and levcromakalim to shorten the VERP. The results showed no difference between IS and DS at both PCLs with or without medication. Recurrent and abrupt rate changes were avoided daring IS, making this the protocol of choice when induction of arrhythmias is to be avoided.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.1994.tb03805.x