Effect of the Intertrain Pause on the Ventricular Effective Refractory Period Measured by the Extrastimulus Technique

This study determined the effect of the duration of the intertrain pause on the ventricular elective refractory period (VERP) measured by the extrastimulus technique using conventional eight‐beat basic drive trains. In 50 subjects, the VERP was measured using a basic drive train cycle length of 500...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 1990-04, Vol.13 (4), p.405-409
Main Authors: MORADY, FRED, KADISH, ALAN H., ROSENHECK, SHIMON, SCHMALTZ, STEPHEN, DEBUITLEIR, MICHAEL
Format: Article
Language:English
Subjects:
Action Potentials - physiology
Cardiac Catheterization
Cardiac Pacing, Artificial
Electric Stimulation
Female
Heart - physiopathology
Heart Ventricles
Humans
intertrain pause
Male
Middle Aged
Myocardial Contraction - physiology
Neural Conduction - physiology
Refractory Period, Electrophysiological - physiology
Tachycardia - physiopathology
Time Factors
ventricular refractoriness
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Summary:This study determined the effect of the duration of the intertrain pause on the ventricular elective refractory period (VERP) measured by the extrastimulus technique using conventional eight‐beat basic drive trains. In 50 subjects, the VERP was measured using a basic drive train cycle length of 500 msec, 2‐msec steps in the extrastimulus coupling interval, and intertrain pauses of 0, 1, 4, 8, 20, 40, 60, or 380 seconds. The VERP increased significantly with each stepwise increment in the intertrain pause up to 20 seconds, then reached a plateau. The VERP measured with an intertrain pause of 20 seconds was a mean of 13 msec longer than when measured with a conventional 4‐second pause. The results of this study demonstrate a direct relationship between the VERP and the duration of the pause separating the eight‐beat basic drive trains used to measure the VERP. When the cycle length of the basic drive train is 500 msec, the VERP lengthens as the duration of the intertrain pause increases from 1 to 20 seconds, demonstrating that the basic drive trains exert a cumulative effect on the VERP when the intertrain pause is shorter than 20 seconds. A cumulative effect of the basic drive trains on the VERP is lost when the intertrain pause is 20 seconds or more.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.1990.tb02054.x