Key Points
- To determine the spatial relationship between regional myocardial blood flow and epicardial electrical activation during early ventricular arrhythmias following acute coronary occlusion.
- Examined eight open-chest anaesthetised dogs subjected to proximal left anterior descending coronary artery occlusion.
- Recorded blood flow and electrical activation at 80 epicardial and endocardial sites across a 4 x 5 cm left ventricular area using three-dimensional computer mapping.
- Mean blood flow within the ischaemic zone dropped to 0.27 cm3·g-1·min-1 in the epicardium and 0.24 cm3·g-1·min-1 in the endocardium.
- Marked epicardial activation delays and conduction fragmentation occurred exclusively in regions with blood flow under 0.3 cm3·g-1·min-1 (representing 71% of epicardial and 74% of endocardial samples), revealing pronounced spatial flow heterogeneity.
Structured PICO
PPopulation8 open chest anaesthetised dogs
IInterventionProximal occlusion of the left anterior descending coronary artery
OOutcomeRelation between patterns of flow and epicardial activation at the time of onset of early ventricular arrhythmiassurrogate
Local spatial variability in myocardial blood flow within the central ischemic region may be a prerequisite for abnormal conduction fractionation leading to early ventricular arrhythmias.