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Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia

INTRODUCTION: High beat-to-beat morphological variation (divergence) on the ventricular electrogram during programmed ventricular stimulation (PVS) is associated with increased risk of ventricular fibrillation (VF), with unclear mechanisms. We hypothesized that ventricular divergence is associated w...

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Autores principales: Hsieh, Yu-Cheng, Hsieh, Wan-Hsin, Li, Cheng-Hung, Liao, Ying-Chieh, Lin, Jiunn-Cherng, Weng, Chi-Jen, Lo, Men-Tzung, Tuan, Ta-Chuan, Lin, Shien-Fong, Yeh, Hung-I, Huang, Jin-Long, Haugan, Ketil, Larsen, Bjarne D., Lin, Yenn-Jiang, Lin, Wei-Wen, Wu, Tsu-Juey, Chen, Shih-Ann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034916/
https://www.ncbi.nlm.nih.gov/pubmed/32084145
http://dx.doi.org/10.1371/journal.pone.0228818
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author Hsieh, Yu-Cheng
Hsieh, Wan-Hsin
Li, Cheng-Hung
Liao, Ying-Chieh
Lin, Jiunn-Cherng
Weng, Chi-Jen
Lo, Men-Tzung
Tuan, Ta-Chuan
Lin, Shien-Fong
Yeh, Hung-I
Huang, Jin-Long
Haugan, Ketil
Larsen, Bjarne D.
Lin, Yenn-Jiang
Lin, Wei-Wen
Wu, Tsu-Juey
Chen, Shih-Ann
author_facet Hsieh, Yu-Cheng
Hsieh, Wan-Hsin
Li, Cheng-Hung
Liao, Ying-Chieh
Lin, Jiunn-Cherng
Weng, Chi-Jen
Lo, Men-Tzung
Tuan, Ta-Chuan
Lin, Shien-Fong
Yeh, Hung-I
Huang, Jin-Long
Haugan, Ketil
Larsen, Bjarne D.
Lin, Yenn-Jiang
Lin, Wei-Wen
Wu, Tsu-Juey
Chen, Shih-Ann
author_sort Hsieh, Yu-Cheng
collection PubMed
description INTRODUCTION: High beat-to-beat morphological variation (divergence) on the ventricular electrogram during programmed ventricular stimulation (PVS) is associated with increased risk of ventricular fibrillation (VF), with unclear mechanisms. We hypothesized that ventricular divergence is associated with epicardial wavebreaks during PVS, and that it predicts VF occurrence. METHOD AND RESULTS: Langendorff-perfused rabbit hearts (n = 10) underwent 30-min therapeutic hypothermia (TH, 30°C), followed by a 20-min treatment with rotigaptide (300 nM), a gap junction modifier. VF inducibility was tested using burst ventricular pacing at the shortest pacing cycle length achieving 1:1 ventricular capture. Pseudo-ECG (p-ECG) and epicardial activation maps were simultaneously recorded for divergence and wavebreaks analysis, respectively. A total of 112 optical and p-ECG recordings (62 at TH, 50 at TH treated with rotigaptide) were analyzed. Adding rotigaptide reduced ventricular divergence, from 0.13±0.10 at TH to 0.09±0.07 (p = 0.018). Similarly, rotigaptide reduced the number of epicardial wavebreaks, from 0.59±0.73 at TH to 0.30±0.49 (p = 0.036). VF inducibility decreased, from 48±31% at TH to 22±32% after rotigaptide infusion (p = 0.032). Linear regression models showed that ventricular divergence correlated with epicardial wavebreaks during TH (p<0.001). CONCLUSION: Ventricular divergence correlated with, and might be predictive of epicardial wavebreaks during PVS at TH. Rotigaptide decreased both the ventricular divergence and epicardial wavebreaks, and reduced the probability of pacing-induced VF during TH.
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spelling pubmed-70349162020-02-27 Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia Hsieh, Yu-Cheng Hsieh, Wan-Hsin Li, Cheng-Hung Liao, Ying-Chieh Lin, Jiunn-Cherng Weng, Chi-Jen Lo, Men-Tzung Tuan, Ta-Chuan Lin, Shien-Fong Yeh, Hung-I Huang, Jin-Long Haugan, Ketil Larsen, Bjarne D. Lin, Yenn-Jiang Lin, Wei-Wen Wu, Tsu-Juey Chen, Shih-Ann PLoS One Research Article INTRODUCTION: High beat-to-beat morphological variation (divergence) on the ventricular electrogram during programmed ventricular stimulation (PVS) is associated with increased risk of ventricular fibrillation (VF), with unclear mechanisms. We hypothesized that ventricular divergence is associated with epicardial wavebreaks during PVS, and that it predicts VF occurrence. METHOD AND RESULTS: Langendorff-perfused rabbit hearts (n = 10) underwent 30-min therapeutic hypothermia (TH, 30°C), followed by a 20-min treatment with rotigaptide (300 nM), a gap junction modifier. VF inducibility was tested using burst ventricular pacing at the shortest pacing cycle length achieving 1:1 ventricular capture. Pseudo-ECG (p-ECG) and epicardial activation maps were simultaneously recorded for divergence and wavebreaks analysis, respectively. A total of 112 optical and p-ECG recordings (62 at TH, 50 at TH treated with rotigaptide) were analyzed. Adding rotigaptide reduced ventricular divergence, from 0.13±0.10 at TH to 0.09±0.07 (p = 0.018). Similarly, rotigaptide reduced the number of epicardial wavebreaks, from 0.59±0.73 at TH to 0.30±0.49 (p = 0.036). VF inducibility decreased, from 48±31% at TH to 22±32% after rotigaptide infusion (p = 0.032). Linear regression models showed that ventricular divergence correlated with epicardial wavebreaks during TH (p<0.001). CONCLUSION: Ventricular divergence correlated with, and might be predictive of epicardial wavebreaks during PVS at TH. Rotigaptide decreased both the ventricular divergence and epicardial wavebreaks, and reduced the probability of pacing-induced VF during TH. Public Library of Science 2020-02-21 /pmc/articles/PMC7034916/ /pubmed/32084145 http://dx.doi.org/10.1371/journal.pone.0228818 Text en © 2020 Hsieh et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hsieh, Yu-Cheng
Hsieh, Wan-Hsin
Li, Cheng-Hung
Liao, Ying-Chieh
Lin, Jiunn-Cherng
Weng, Chi-Jen
Lo, Men-Tzung
Tuan, Ta-Chuan
Lin, Shien-Fong
Yeh, Hung-I
Huang, Jin-Long
Haugan, Ketil
Larsen, Bjarne D.
Lin, Yenn-Jiang
Lin, Wei-Wen
Wu, Tsu-Juey
Chen, Shih-Ann
Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia
title Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia
title_full Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia
title_fullStr Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia
title_full_unstemmed Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia
title_short Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia
title_sort ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034916/
https://www.ncbi.nlm.nih.gov/pubmed/32084145
http://dx.doi.org/10.1371/journal.pone.0228818
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