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
Distribution of Excitation Frequencies on the Epicardial and Endocardial Surfaces of Fibrillating Ventricular Wall of the Sheep Heart
TL;DR: Observed frequency patterns during VT/VF suggest that the underlying mechanism may be a sustained intramural reentrant source interacting with tissue heterogeneities.
Journal ArticleDOI
The Brugada syndrome.
TL;DR: The recently highlighted form of idiopathic ventricular tachycardia (VT) and VF, referred to as the Brugada syndrome, is characterized by ST segment elevation in the right precordial (V, to V,) ECG leads, often but not always accompanied by an apparent right bundle branch block**.
Journal ArticleDOI
Cellular basis for QT dispersion
TL;DR: The data indicate that the interval delimited by the peak and the end of the T wave represents an accurate measure of regional dispersion of repolarization across the ventricular wall and as such may be a valuable index for assessment of arrhythmic risk.
Journal ArticleDOI
Further Characterization of the Syndrome of Right Bundle Branch Block, ST Segment Elevation, and Sudden Cardiac Death
Josep Brugada,Pedro Brugada +1 more
TL;DR: Long‐term follow‐up of survivors failed to show progression to any form of right or left ventricular cardiomyopatby, especially those related to asymptomatic and intermittent forms.
Journal ArticleDOI
Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiographic leads: a Brugada syndrome variant?
TL;DR: Adjunctive treatment with amiodarone reduced J wave amplitude, preventing ventricular fibrillation and ICD shocks, and may serve as an important diagnostic sign to detect high‐risk individuals with a history of unexplained syncope.
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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