Presentation is loading. Please wait.

Presentation is loading. Please wait.

Spatiotemporal characterization of the transition from sinus rhythm to ventricular fibrillation during an acute ischemic event in the intact human heart.

Published byHolly Rose Modified over 5 years ago

Similar presentations

Presentation on theme: "Spatiotemporal characterization of the transition from sinus rhythm to ventricular fibrillation during an acute ischemic event in the intact human heart."— Presentation transcript:

1 Spatiotemporal characterization of the transition from sinus rhythm to ventricular fibrillation during an acute ischemic event in the intact human heart by whole-heart sock- mapping  Michele Orini, PhD, Peter Taggart, MD, DSc, FRCP, Martin Hayward, MS, FRCS, Pier D. Lambiase, PhD, FRCP, FHRS  HeartRhythm Case Reports  Volume 3, Issue 5, Pages (May 2017) DOI: /j.hrcr Copyright © 2017 Heart Rhythm Society Terms and Conditions

2 Figure 1 A: Evolution of a unipolar electrogram from inside the ischemic region including early sinus rhythm, ventricular pacing, late sinus rhythm, and ventricular tachycardia / ventricular fibrillation. B: Detailed representation of morphologic changes in unipolar electrograms from sites P0 to P3 (see Figure 2) during the progression of ischemia. From interval T1 to T4, site P0 (outside the ischemic region) shows broadening QRS and mild changes in the T wave; P1 (border-zone region) shows progressive activation time (AT) delay (shift in the S wave) and T-wave alternans (TWA); P2–P3 (inside the ischemic region) show ST-segment elevation, AT delay, TWA, QRS alternans, and conduction block. Site P3 also shows QRS fractionation during T2. HeartRhythm Case Reports 2017 3, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

3 Figure 2 A: Diagram of the multielectrode sock with circles representing electrodes; B: ST-segment elevation/depression during sinus rhythm prior to ventricular pacing; C: Maximum activation time (AT) delay; D: T-wave alternans (TWA); E: QRS alternans (QRSA); F: conduction block. Parameters in C–F are derived from recordings during pacing. The average magnitudes of QRSA and TWA are measured as multiples of the level of statistical significance (V/Vth). The white star represents the pacing site. Points P0–P3 mark cardiac sites outside, at the border zone of, and inside the ischemic region, respectively. Unipolar electrograms from these sites are reported in Figure 1. LV = left ventricle; RV = right ventricle. HeartRhythm Case Reports 2017 3, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

4 Figure 3 Temporal evolution of electrophysiological abnormalities. A: Propagation of alternans throughout the epicardium, described as the number of sites with significant QRS alternans (QRSA) and T-wave alternans (TWA). B: Distribution of activation time (AT) delay throughout the epicardium. IQR = interquartile range; med = median. C: Temporal evolution of proportion of sites showing concordant alternans (gray region indicating the same BA patterns, where the T-wave amplitude of the odd beat is larger than that of the even beat) and discordant alternans (red region indicating opposite AB pattern). D: TWA magnitude over time. HeartRhythm Case Reports 2017 3, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Download ppt "Spatiotemporal characterization of the transition from sinus rhythm to ventricular fibrillation during an acute ischemic event in the intact human heart."

Similar presentations

Date of download: 7/7/2016 Copyright © The American College of Cardiology. All rights reserved. From: Endocardial and Epicardial Repolarization Alternans.

Date of download: 7/7/2016 Copyright © The American College of Cardiology. All rights reserved. From: Endocardial and Epicardial Repolarization Alternans.
Epicardial access and ventricular tachycardia ablation in a postmyocarditis patient using a nonfluoroscopic catheter visualization system  Akiko Ueda,

Epicardial access and ventricular tachycardia ablation in a postmyocarditis patient using a nonfluoroscopic catheter visualization system  Akiko Ueda,
Abnormal epicardial electrophysiologic substrate in patients with early repolarization pattern and reduced left ventricular systolic function: A report.

Abnormal epicardial electrophysiologic substrate in patients with early repolarization pattern and reduced left ventricular systolic function: A report.
HeartRhythm Case Reports

HeartRhythm Case Reports
Volume 7, Issue 1, Pages (January 2010)

Volume 7, Issue 1, Pages (January 2010)
Volume 15, Issue 7, Pages (July 2018)

Volume 15, Issue 7, Pages (July 2018)
Ellis Rochelson, MD, Lynn Nappo, RN, Robert H. Pass, MD 

Ellis Rochelson, MD, Lynn Nappo, RN, Robert H. Pass, MD 
Radiofrequency ablation of premature ventricular contractions originating from the aortomitral continuity localized by use of a novel noninvasive epicardial.

Radiofrequency ablation of premature ventricular contractions originating from the aortomitral continuity localized by use of a novel noninvasive epicardial.
Wolff-Parkinson-White syndrome due to a left atrial appendage–to–left ventricular connection: A case of a successful pathway elimination from inside of.

Wolff-Parkinson-White syndrome due to a left atrial appendage–to–left ventricular connection: A case of a successful pathway elimination from inside of.
Volume 15, Issue 4, Pages (April 2018)

Volume 15, Issue 4, Pages (April 2018)
Incessant bundle branch reentrant ventricular tachycardia in a patient with corrected transposition of the great arteries  Ken Kato, MD, Daigo Yagishita,

Incessant bundle branch reentrant ventricular tachycardia in a patient with corrected transposition of the great arteries  Ken Kato, MD, Daigo Yagishita,
Successful ablation of premature ventricular contractions originating from the inferoseptal process of the left ventricle using a coronary sinus approach 

Successful ablation of premature ventricular contractions originating from the inferoseptal process of the left ventricle using a coronary sinus approach 
Isolated left bundle branch block progressing to complete heart block and asystole: A novel presentation of a desmin mutation  Addison S. Gearhart, MD,

Isolated left bundle branch block progressing to complete heart block and asystole: A novel presentation of a desmin mutation  Addison S. Gearhart, MD,
Differences in the upslope of the precordial body surface ECG T wave reflect right to left dispersion of repolarization in the intact human heart  Neil.

Differences in the upslope of the precordial body surface ECG T wave reflect right to left dispersion of repolarization in the intact human heart  Neil.
Recurrent commotio cordis: Déjà vu

Recurrent commotio cordis: Déjà vu
Volume 14, Issue 12, Pages (December 2017)

Volume 14, Issue 12, Pages (December 2017)
A case of paroxysmal atrioventricular block–induced cardiac arrest

A case of paroxysmal atrioventricular block–induced cardiac arrest
Left ventricle penetration—A rare complication of transseptal puncture and catheter ablation for supraventricular tachycardia  Nelson Chavarria, MD, Seth.

Left ventricle penetration—A rare complication of transseptal puncture and catheter ablation for supraventricular tachycardia  Nelson Chavarria, MD, Seth.
Challenges in the diagnosis and management of idiopathic ventricular fibrillation  Jonathan Lipton, MD, PhD, George J. Klein, MD, Raymond W. Sy, MBBS,

Challenges in the diagnosis and management of idiopathic ventricular fibrillation  Jonathan Lipton, MD, PhD, George J. Klein, MD, Raymond W. Sy, MBBS,
A case of scar-related ventricular tachycardia demonstrating termination with nonglobal capture at the site of concealed entrainment with dual slow conduction.

A case of scar-related ventricular tachycardia demonstrating termination with nonglobal capture at the site of concealed entrainment with dual slow conduction.

Similar presentations

Ads by Google