| Autor: |
Jalil, Elise, Le Franc, Pierre, Lebeau, Réal, Molin, Franck, Costi, Paulo, Kús, Teresa |
| Předmět: |
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| Zdroj: |
Pacing & Clinical Electrophysiology; Mar1998, Vol. 21 Issue 3, p528-535, 8p |
| Abstrakt: |
The composition of the excitable gap (EG) in common atrial flutter (AFI) was determined before and during infusion of procainamide (PA) in 9 patients (6 men and 3 women; age 70 ± 7 years). The EG was determined by introducing a premature stimulus after every 20th AFI complex detected using a quadripolar electrode catheter placed just above the tricuspid valve. fliastole was scanned in 2- to 4-ms decrements to the atrial effective refractory period (ERP), The relationship between the coupling interval and the return cycle length (CL) determined a reset-response curve (ERG), which described the EQ. PA (15 mg/kgj was administered during API over 30 minutes and RRC was repeated at maximum API PA prolonged API CL from 227 ± 29 to 296 ± 62 ms (P <0.01) but did not terminate API. ERP during AFI prolonged from 169 ±24 to219 ± 41 ms(P <0.01). Control EG was 57 ± 16 ms or 25% ± 6% of API CL and on PA HG was 77 ± 30 ms (P = 0.01), which was still 26% ± 7% of the CL. Without drug, EEC was mixed in eight cases demonstrating an EG composed of fully excitable tissue (10 ± 4 ms or 19% ± 10% of the EG) and partially refractory tissue (48 ± 18 ms). PA did not change the duration of the fully excitable region (13 ± 10 ms or 19% 15% of EG). Peak PA plasma concentration was 47 ± 20μmol/L. PA prolonged AFI CL, ERP, and EG duration but did not change the proportion of 44F1 CL occupied by the EG. The persistance of fully excitable tissue at the head of the wavefront in the presence of PA may largely explain its inefficacy in the acute termination of common AFI. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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