Maximal postextrasystolic potentiation following multiple extrasystoles: A simple means of myocardial assessment

To obtain consistent, reproducible postextrasystolic potentiation (PESP), a single closely coupled extrasystole (ES) must be introduced using transvenous pacing. We hypothesized that multiple ES (spontaneous or catheter induced) produce maximal PESP at all coupling intervals (CI). Differences in PESP between single and double ES were assessed in dogs at varying CI by two different methods [systolic time intervals--PEP/LVET, and endocardial markers--ejection fraction (EF)]. Single ES produced variable decreases in PEP/LVET (-8.6 +/- 2.7% (SE) to -22.9 +/- 4.0%) depending on the CI duration. Double ES produced maximal decreases (-26.0 +/- 1.2%) at all CI. A similar relationship was noted for EF following single ES (8.6 +/- 2.7% to 43.0 +/- 4.0%) and double ES (42.9 +/- 1.3%). Double ES produced maximal PESP at all CI. This finding may allow simple myocardial assessment during routine left ventricular catheterization without simultaneous right ventricular catheterization.