What question did this study set out to answer?

The study aims to understand how dispersion of refractory periods in noninfarcted myocardium contributes to the transition from ventricular tachycardia to ventricular fibrillation after myocardial infarction.

May 15, 1995Circulation

Dispersion of ‘Refractoriness’ in Noninfarcted Myocardium of Patients With Ventricular Tachycardia or Ventricular Fibrillation After Myocardial Infarction

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Why the study?

Is spatial dispersion of refractoriness in noninfarcted myocardium greater in patients with postinfarction VF compared to those with postinfarction VT?

Population

14 patients undergoing antiarrhythmic surgery for symptomatic, drug-refractory, postinfarction ventricular…

Comparison

Measurement of local fibrillation intervals at… vs Patients with hemodynamically tolerable…

Design

Cross-sectional

Authors

AMAnand R. Ramdat MisierIsala TOTobias OpthofElectrophysiology NHNorbert M. van HemelUniversity Medical Center Utrecht

Discussion

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Implication

May aid post-MI VF risk stratification; leaves open causal role and need for prospective validation before practice change.

Key Points

The study aims to understand how dispersion of refractory periods in noninfarcted myocardium contributes to the transition from ventricular tachycardia to ventricular fibrillation after myocardial infarction.
Measured local fibrillation intervals at 32 to 64 sites in the noninfarcted left ventricle during antiarrhythmic surgery
Patients included those with sustained VT and those with cardiac arrest due to VF
Used a grid of electrodes placed on the epicardium remote from infarcted tissue.
The spatial dispersion of VF intervals was significantly greater in the VF group (3.63 +/- 0.56) compared to the VT group (1.55 +/- 0.40); P < .01
Differences between shortest and longest VF intervals were larger in the VF group (P < .02)
The largest difference between adjacent sites was also greater in the VF group (P < .05).

Structured PICO

Is spatial dispersion of refractoriness in noninfarcted myocardium greater in patients with postinfarction VF compared to those with postinfarction VT?

Population

14 patients undergoing antiarrhythmic surgery for symptomatic, drug-refractory, postinfarction ventricular tachyarrhythmias (7 with hemodynamically tolerable sustained VT, 7 with cardiac arrest and documented VF)

Intervention

Measurement of local fibrillation intervals at 32 to 64 sites in the noninfarcted part of the left ventricle using an epicardial electrode grid during induced VF on cardiopulmonary bypass

Comparator

Patients with hemodynamically tolerable sustained VT (VT group) versus patients with cardiac arrest and documented VF (VF group)

Outcome

Spatial dispersion of VF intervals (expressed as the coefficient of variation of VF intervals)surrogate

Patients with postinfarction VF exhibit greater spatial dispersion of refractoriness in noninfarcted myocardium compared to those with postinfarction VT, suggesting a mechanism for the degeneration of VT into VF.

Cite This Study

Misier et al. (1995) studied this question.

synapsesocial.com/papers/6a0fdd4e4fb650da4ffe9767 https://doi.org/10.1161/01.cir.91.10.2566

Topics

Ventricular arrhythmias

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Dispersion of ‘Refractoriness’ in Noninfarcted Myocardium of Patients With Ventricular Tachycardia or Ventricular Fibrillation After Myocardial Infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Dispersion of ‘Refractoriness’ in Noninfarcted Myocardium of Patients With Ventricular Tachycardia or Ventricular Fibrillation After Myocardial Infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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