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

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...

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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
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container_issue Suppl_1 Suppl 1
container_start_page A18547
container_title Circulation (New York, N.Y.)
container_volume 134
creator Wijers, Sofieke C
Bossu, Alexandre
Sprenkeler, David J
Dunnink, Albert
Beekman, Jet D
Varkevisser, Rosanne
Aranda Hernández, Alfonso
Meine, Mathias
Vos, Marc A
description 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
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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&lt;0.01). 2a) STVRVARI increased from 2.82±0.33 to 3.77±0.69ms (p=0.001). Spearmans rho between STVRVMAPD and STVRVARI was 0.42 (p&lt;0.05). 2b) Under awake conditions. 4/8 subjects were inducible with cisapride. In the inducible subjects a significant increase in STVRVARI was observed in the first hour after cisapride from 2.65±0.55 to 3.56±0.30ms (p=0.03).ConclusionBehavior of STV derived from the RV is comparable to the LV. STVRVARI increases significantly before the occurrence of an arrhythmia in awake and anaesthetized conditions. This can be integrated in devices to 24/7 monitor arrhythmic (in)stability and initiate and or modify antiarrhythmic therapies.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><language>eng</language><publisher>by the American College of Cardiology Foundation and the American Heart Association, Inc</publisher><ispartof>Circulation (New York, N.Y.), 2016-11, Vol.134 (Suppl_1 Suppl 1), p.A18547-A18547</ispartof><rights>2016 by the American College of Cardiology Foundation and the American Heart Association, Inc.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids></links><search><creatorcontrib>Wijers, Sofieke C</creatorcontrib><creatorcontrib>Bossu, Alexandre</creatorcontrib><creatorcontrib>Sprenkeler, David J</creatorcontrib><creatorcontrib>Dunnink, Albert</creatorcontrib><creatorcontrib>Beekman, Jet D</creatorcontrib><creatorcontrib>Varkevisser, Rosanne</creatorcontrib><creatorcontrib>Aranda Hernández, Alfonso</creatorcontrib><creatorcontrib>Meine, Mathias</creatorcontrib><creatorcontrib>Vos, Marc A</creatorcontrib><title>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</title><title>Circulation (New York, N.Y.)</title><description>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&lt;0.01). 2a) STVRVARI increased from 2.82±0.33 to 3.77±0.69ms (p=0.001). Spearmans rho between STVRVMAPD and STVRVARI was 0.42 (p&lt;0.05). 2b) Under awake conditions. 4/8 subjects were inducible with cisapride. In the inducible subjects a significant increase in STVRVARI was observed in the first hour after cisapride from 2.65±0.55 to 3.56±0.30ms (p=0.03).ConclusionBehavior of STV derived from the RV is comparable to the LV. STVRVARI increases significantly before the occurrence of an arrhythmia in awake and anaesthetized conditions. This can be integrated in devices to 24/7 monitor arrhythmic (in)stability and initiate and or modify antiarrhythmic therapies.</description><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNqdUEtOwzAQjRBIlM8d5gKW8m0ouzRtBQs2FbCtjDPUJq4tjaeJelxuglMhDsBsnt6T3kdzkcyyKi9FWRWLy2SWpulC1EWeXyc3IXxFOi_qapZ8Nx-BSSqG7KEq60dYomTBXkwI75KMZONdAOOgUWyGM4UtKj8gneDZMdIgLayQzIAdbMgfgDXC1ux1TEDHZNTRSoK1RcXk9yQP0EoHL94Z9gQNkT6xPhgVTaGHN9dhVB2GmMNRla6DZpQ9QutdZ_4GTTWtphijoIk1cdK5bSpbWq96WPn9XXL1KW3A-1-8TcrN-rV9EqO3cXvo7XFE2mmUlvUuPiYt0qwWeZrNs-lEmtdVVvzT9gMdJHwQ</recordid><startdate>20161111</startdate><enddate>20161111</enddate><creator>Wijers, Sofieke C</creator><creator>Bossu, Alexandre</creator><creator>Sprenkeler, David J</creator><creator>Dunnink, Albert</creator><creator>Beekman, Jet D</creator><creator>Varkevisser, Rosanne</creator><creator>Aranda Hernández, Alfonso</creator><creator>Meine, Mathias</creator><creator>Vos, Marc A</creator><general>by the American College of Cardiology Foundation and the American Heart Association, Inc</general><scope/></search><sort><creationdate>20161111</creationdate><title>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</title><author>Wijers, Sofieke C ; Bossu, Alexandre ; Sprenkeler, David J ; Dunnink, Albert ; Beekman, Jet D ; Varkevisser, Rosanne ; Aranda Hernández, Alfonso ; Meine, Mathias ; Vos, Marc A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-wolterskluwer_health_00003017-201611111-027513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Wijers, Sofieke C</creatorcontrib><creatorcontrib>Bossu, Alexandre</creatorcontrib><creatorcontrib>Sprenkeler, David J</creatorcontrib><creatorcontrib>Dunnink, Albert</creatorcontrib><creatorcontrib>Beekman, Jet D</creatorcontrib><creatorcontrib>Varkevisser, Rosanne</creatorcontrib><creatorcontrib>Aranda Hernández, Alfonso</creatorcontrib><creatorcontrib>Meine, Mathias</creatorcontrib><creatorcontrib>Vos, Marc A</creatorcontrib><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wijers, Sofieke C</au><au>Bossu, Alexandre</au><au>Sprenkeler, David J</au><au>Dunnink, Albert</au><au>Beekman, Jet D</au><au>Varkevisser, Rosanne</au><au>Aranda Hernández, Alfonso</au><au>Meine, Mathias</au><au>Vos, Marc A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><date>2016-11-11</date><risdate>2016</risdate><volume>134</volume><issue>Suppl_1 Suppl 1</issue><spage>A18547</spage><epage>A18547</epage><pages>A18547-A18547</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><abstract>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&lt;0.01). 2a) STVRVARI increased from 2.82±0.33 to 3.77±0.69ms (p=0.001). Spearmans rho between STVRVMAPD and STVRVARI was 0.42 (p&lt;0.05). 2b) Under awake conditions. 4/8 subjects were inducible with cisapride. In the inducible subjects a significant increase in STVRVARI was observed in the first hour after cisapride from 2.65±0.55 to 3.56±0.30ms (p=0.03).ConclusionBehavior of STV derived from the RV is comparable to the LV. STVRVARI increases significantly before the occurrence of an arrhythmia in awake and anaesthetized conditions. This can be integrated in devices to 24/7 monitor arrhythmic (in)stability and initiate and or modify antiarrhythmic therapies.</abstract><pub>by the American College of Cardiology Foundation and the American Heart Association, Inc</pub></addata></record>
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title 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
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