Journal ArticleDOI
Cellular Basis for the Electrocardiographic J Wave
Gan-Xin Yan,Charles Antzelevitch +1 more
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TLDR
The results provide the first direct evidence in support of the hypothesis that heterogeneous distribution of a transient outward current-mediated spike-and-dome morphology of the action potential across the ventricular wall underlies the manifestation of the electrocardiographic J wave.Abstract:
Background The J wave is a deflection that appears in the ECG as a late delta wave following the QRS or as a small secondary R wave (R′). Also referred to as an Osborn wave, the J wave has been observed in the ECG of animals and humans for more than four decades, yet the mechanism underlying its manifestation is poorly understood. The present study investigates the cellular basis for the J wave using an isolated arterially perfused preparation consisting of a wedge of canine right or left ventricle. Methods and Results A 12-lead ECG was initially recorded in vivo. After isolation and arterial perfusion of the right or left ventricular wedge, transmembrane action potentials were simultaneously recorded from epicardial, M region, and endocardial transmural sites with three floating microelectrodes. A transmural ECG was recorded concurrently. A J wave was observed at the R-ST junction of the ECG in 17 of 20 adult dogs, usually in leads II, III, aVR, and aVF and the mid to lateral precordial leads. The J wave...read more
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Journal ArticleDOI
Electrocardiographic Characteristics and SCN5A Mutations in Idiopathic Ventricular Fibrillation Associated with Early Repolarization
Hiroshi Watanabe,Akihiko Nogami,Kimie Ohkubo,Hiro Kawata,Yuka Hayashi,Taisuke Ishikawa,Takeru Makiyama,Satomi Nagao,Nobue Yagihara,Naofumi Takehara,Yuichiro Kawamura,Akinori Sato,Kazuki Okamura,Yukio Hosaka,Masahito Sato,Satoki Fukae,Masaomi Chinushi,Hirotaka Oda,Masaaki Okabe,Akinori Kimura,Koji Maemura,Ichiro Watanabe,Shiro Kamakura,Minoru Horie,Yoshifusa Aizawa,Wataru Shimizu,Naomasa Makita +26 more
TL;DR: These findings support the hypothesis that decreased sodium current enhances ventricular fibrillation susceptibility and identify nonsynonymous variants in SCN5A (resulting in A226D, L846R, and R367H) in 3 unrelated patients.
Journal ArticleDOI
Naming of the Waves in the ECG, With a Brief Account of Their Genesis
TL;DR: The purpose of this presentation is to tell the stories of the naming of the waves in the ECG and to discuss briefly the electrical activity that produces them.
Journal ArticleDOI
Phase 2 Reentry as a Trigger to Initiate Ventricular Fibrillation During Early Acute Myocardial Ischemia
Gan-Xin Yan,Ajay K. Joshi,Donglin Guo,Thinn Hlaing,Jack L. Martin,Xiaoping Xu,Peter R. Kowey +6 more
TL;DR: Acute regional myocardial ischemia results in markedly heterogeneous loss of Ito-mediated epicardial AP domes across the ischemic border, leading to phase 2 reentry, which can in turn produce an R-on-T extrasystole capable of initiating VF.
Journal ArticleDOI
Ventricular hypertrophy amplifies transmural repolarization dispersion and induces early afterdepolarization.
Gan-Xin Yan,Seth J. Rials,Ying Wu,Tengxian Liu,Xiaoping Xu,Roger A. Marinchak,Peter R. Kowey +6 more
TL;DR: This study provides the first direct evidence from intracellular recordings that phase 2 EAD could be generated from rabbit intact hypertrophied LV wall in the absence of APD prolonging agents, resulting in R on T extrasystoles capable of initiating polymorphic VT under enhanced TDR.
Journal ArticleDOI
Genetic, molecular and cellular mechanisms underlying the J wave syndromes.
TL;DR: The clinical and genetic aspects as well as the cellular and molecular mechanisms underlying the J wave syndromes are reviewed, highlighting the need to identify those at risk for sudden cardiac death.
References
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Journal ArticleDOI
Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report.
Pedro Brugada,Josep Brugada +1 more
TL;DR: Common clinical and ECG features define a distinct syndrome in this group of patients with recurrent episodes of aborted sudden death unexplainable by currently known diseases, not explainable by electrolyte disturbances, ischemia or structural heart disease.
Journal ArticleDOI
Heterogeneity within the ventricular wall. Electrophysiology and pharmacology of epicardial, endocardial, and M cells.
Charles Antzelevitch,Serge Sicouri,Silvio H. Litovsky,Anton Lukas,S C Krishnan,J. M. Di Diego,G. A. Gintant,Da-Wei Liu +7 more
TL;DR: In spite of important advances in cardiology in recent years, pharmacological control of cardiac arrhythmias in the clinic remains an experiment conducted on a patient-by-patient basis using a trial and error approach tempered by good clinical judgment.
Journal ArticleDOI
Inward current channels activated by intracellular Ca in cultured cardiac cells.
TL;DR: Researchers report here studies on single channel currents recorded from heart muscle cells, in which they have found a channel, abundant in cardiac membrane, which does not seem to belong in any of the familiar categories.
Journal ArticleDOI
Characteristics of the Delayed Rectifier Current (IKr and IKs) in Canine Ventricular Epicardial, Midmyocardial, and Endocardial Myocytes A Weaker IKs Contributes to the Longer Action Potential of the M Cell
Da-Wei Liu,Charles Antzelevitch +1 more
TL;DR: The results suggest that the distinctive phase-3 repolarization features of M cells are due in part to a lesser contribution of IKs and that this distinction may also explain why M Cells are the main targets for agents that prolong APD in ventricular myocardium.
Journal ArticleDOI
Influences of anisotropic tissue structure on reentrant circuits in the epicardial border zone of subacute canine infarcts.
TL;DR: It is proposed that the parallel orientation of the muscle bundles in the epicardial border zone is an important cause of ventricular tachycardia because activation transverse to myocardial fibers is sufficiently slow to permit the occurrence of reentry.
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