Key result
In a canine model of coronary reperfusion, 58% of observed ventricular tachycardias had a focal Purkinje origin, suggesting Purkinje tissue is important in the genesis of reperfusion VT.
Purkinje tissue appears to play an important role in the genesis of reperfusion-induced ventricular tachycardia.
Hypothesis-generating for Purkinje-targeted strategies in reperfusion VT; requires human validation before clinical consideration.
Previous studies have indicated that the endocardium may be responsible for a large portion of ventricular tachycardia (VT) seen with reperfusion of ischemic myocardium. To evaluate the role of the Purkinje system in nonreentrant VT arising from the endocardium after reperfusion, the anterior descending coronary artery was occluded for 20 min and then reperfused in 23 dogs after instrumentation of the risk zone with 21 multipolar plunge needles. VT with focal Purkinje origin was defined as a focal endocardial VT with Purkinje potentials recorded before the earliest endocardial myopotential. A total of 19 VTs (mean cycle length 214 +/- 2 ms) were observed with 11 (58%) having focal Purkinje origin. Fifty-eight percent of the VTs degenerated to ventricular fibrillation, with occurrences of two or more independent foci per complex (seen in 7 of 11 compared with 1 of 8 nonsustained VTs). In conclusion, these data show that Purkinje tissue may be important in the genesis of reperfusion VT.
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Arnar et al. (2002) studied Ventricular tachycardia after coronary artery reperfusion (n=23). Coronary artery occlusion and reperfusion was evaluated on Ventricular tachycardia with focal Purkinje origin. In a canine model of coronary reperfusion, 58% of observed ventricular tachycardias had a focal Purkinje origin, suggesting Purkinje tissue is important in the genesis of reperfusion VT.
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