Abstract 18547: Beat-to-Beat Variations in Activation Recovery Interval Derived From the Right Ventricular Electrogram Can Monitor Arrhythmic Risk Under Anesthetic and Awake Conditions in the Chronic Atrioventriclar Block Dog

• Published in: Circulation (New York, N.Y.) N.Y.), 2016-11, Vol.134 (Suppl_1 Suppl 1), p.A18547-A18547
• Main Authors: Wijers, Sofieke C, Bossu, Alexandre, Sprenkeler, David J, Dunnink, Albert, Beekman, Jet D, Varkevisser, Rosanne, Aranda Hernández, Alfonso, Meine, Mathias, Vos, Marc A
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

IntroductionIn the chronic atrioventricular block (CAVB) dog model, beat-to-beat variation in repolarization in the left ventricle (LV) quantified as short-term variability of the left monophasic action potential duration (STVLVMAPD) abruptly increases before the first short coupled ectopic beat (EB), specifically in subjects that demonstrate subsequent multiple EBs and repetitive Torsades de Pointes (TdP) arrhythmias. Applicability of STV to monitor arrhythmic risk 24/7 in clinical practice would be feasible through the use of the intracardiac electrogram (EGM) derived from a right ventricle (RV) lead from a pacemaker or implantable cardioverter defibrillator (ICD). Therefore, we performed 1) a retrospective analysis to show that STVRVMAPD is comparable to the STVLVMAPD 2) a prospective analysis to investigate the value of the STV of the activation recovery interval (ARI) derived from the RV EGM (STVRVARI) to monitor arrhythmic risk in anesthetic (2a) and awake (2b) conditions.Methods1) STVLVMAPD and STVRVMAPD were measured in 30 anaesthetized CAVB dogs inducible (≥3TdP) after a challenge with dofetilide. 2a) Under anesthesia 10 inducible CAVB dogs implanted with an ICD with EGM recording capabilities, were challenged with dofetilide to compare STVRVMAP and STVRVARI. 2b) In 8 CAVB dogs oral cisapride (10-20 mg/kg) was administered to provoke arrhythmias in awake conditions.Results1) Both STVLVMAPD and STVRVMAPD significantly increased before occurrence of the first EB (1.29±0.58 to 3.05±1.70ms and 1.11±0.53 to 2.18±1.43ms respectively (p=0.001). Spearmans rho 0.62 (p