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Ventricular activation in normal sinus rhythm: Abnormalities with recurrent sustained tachycardia and a history of myocardial infarction
Journal article   Peer reviewed

Ventricular activation in normal sinus rhythm: Abnormalities with recurrent sustained tachycardia and a history of myocardial infarction

William J. Untereker, Scott R. Spielman, Harvey L. Waxman, Leonard N. Horowitz and Mark E. Josephson
The American journal of cardiology, v 55(8), pp 974-979
1985
DOI: https://doi.org/10.1016/0002-9149(85)90729-5
PMID: 3984885
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Left ventricular activation was studied in 21 patients: 7 with normal electrocardiograms (group I), 7 with prior transmural myocardial infarction (group II) and 7 with prior transmural myocardial infarction (MI) and recurrent sustained ventricular tachycardia (VT) (group III). Fragmented electrograms were defined as those less than 3 mV in amplitude and longer than 60 ms in duration. Such electrograms were found in no group I patients, 6 of 7 group II patients and all 7 group III patients. An average of 2 of the 12 sites mapped in each patient displayed fragmented electrograms in group II; an average of 6 of the 12 sites displayed fragmented electrograms in group III (p < 0.01). Twelve of the 84 total sites mapped in group II displayed fragmented electrograms, whereas 39 of the 84 sites mapped in group III patients did (p < 0.01). The longest fragmented electrogram found in the 6 group II patients in whom such electrograms were found was shorter in duration than the longest electrogram found in each of the 7 group III patients with fragmented electrograms (76 ms vs 135 ms, p < 0.005). The duration of endocardial activation was longer in group II patients (79 ± 7 ms) than in group I patients (39 ± 4 ms, p < 0.001). Duration of activation was also longer in group III patients (151 ± 12 ms) than in either of the other groups (p < 0.001). These results suggest that fragmented electrograms are uncommon in normal persons, common in patients who have sustained MI, and still more common in patients who have sustained MI and have a history of recurrent sustained VT. These electrograms may reflect slow conduction which is a necessary but not sufficient criterion for reentrant VT.

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Web of Science research areas
Cardiac & Cardiovascular Systems
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