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
Citations
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Journal ArticleDOI
The Brugada syndrome : diagnostic criteria and cellular mechanisms
Journal ArticleDOI
ST-segment elevation in the early repolarization syndrome, idiopathic ventricular fibrillation, and the Brugada syndrome: cellular and clinical linkage.
TL;DR: ST-segment elevation in a structurally normal heart is associated with an electrocardiographic (ECG) J wave, which can be observed in the early repolarization syndrome (ERS), idiopathic ventricular fibrillation (VF), and the Brugada syndrome, and their clinical consequences are remarkably different.
Journal ArticleDOI
Localized right ventricular morphological abnormalities detected by electron-beam computed tomography represent arrhythmogenic substrates in patients with the Brugada syndrome
Masahiko Takagi,N Aihara,Sachio Kuribayashi,Atsushi Taguchi,Wataru Shimizu,Takashi Kurita,Kazuhiro Suyama,Shiro Kamakura,S Hamada,M Takamiya +9 more
TL;DR: The sites of morphological abnormalities detected by electron beam CT in patients with the Brugada syndrome were related to the origins of premature ventricular contractions recorded only in the acute phase, which may trigger ventricular fibrillation.
Journal ArticleDOI
Clinical and mechanistic issues in early repolarization of normal variants and lethal arrhythmia syndromes.
TL;DR: There are major unanswered questions relating to the limited ability to determine which individuals with this common electrocardiographic variant are at risk for sudden death, the incomplete understanding of underlying mechanisms, the inadequate information regarding genetic determinants and therapeutic responses, and the unclear relationship between early repolarization and other conditions involving accelerated repolarized and sudden arrhythmic death such as Brugada and short-QT syndromes.
Journal ArticleDOI
ST-segment elevation and ventricular fibrillation without coronary spasm by intracoronary injection of acetylcholine and/or ergonovine maleate in patients with Brugada syndrome
Takashi Noda,Wataru Shimizu,Atsushi Taguchi,Kazuhiro Satomi,Kazuhiro Suyama,Takashi Kurita,Naohiko Aihara,Shiro Kamakura +7 more
TL;DR: The hypothesis that mild ischemia and vagal influences act additively or synergistically with the substrate responsible for the Brugada syndrome to elevate the ST-segment and precipitate VF is supported.
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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