The roles of pacing interval and pacing strength in ventricular fibrillation induced by rapid pacing with 1 : 1 capture

INTRODUCTION: The roles of pacing interval (PI) and pacing strength (PS) in ventricular fibrillation (VF) induced by rapid pacing with 1 : 1 capture remain unclear. MATERIAL AND METHODS: Epicardial unipolar electrograms (UEs) were simultaneously recorded using contact mapping in 11 swine. Activation-recovery interval (ARI) restitution was constructed at 4 sites, i.e. the apex and base of the left and right ventricles, respectively. A steady state pacing (SSP) protocol was performed to induce VF. The longest PI and the lowest PS for inducing VF were recorded. Statistical correlation analysis was performed to determine the relationship between local ARI restitution properties and PI and PS for VF induction. RESULTS: Forty restitution curves were constructed from 11 SSP procedures. The maximal slope (S(max)) of the ARI restitution curve of the right ventricular apex was positively correlated with the PI for VF induction (r = 0.761, p < 0.05). Spatial dispersions of ARI and S(max) were negatively correlated with the PS for VF induction (r = –0.626 and r = –0.722, respectively, both p < 0.05). CONCLUSIONS: Ventricular fibrillation can be induced by rapid ventricular pacing with 1 : 1 capture. The PI for VF induction was related to the S(max) of the ARI restitution curve of the right ventricular apex, while PS for VF induction was associated with the spatial dispersions of ARI and its restitution property.