OBJECTIVETo investigate electrophysiological characteristics of the coronary sinus musculature and explore its role on electrical conduction between left atrium and right atrium in isolated canine heart.

METHODThe electrical connections between coronary sinus, left atrium and right atrium were detected by programmed stimulation delivered at coronary sinus ostium, distal coronary sinus and lateral wall of left atrium in a Langendorff model of canine.

RESULTSDuring stimulation delivered at coronary sinus ostium and distal coronary sinus, posterior wall of left atrium was firstly activated by electronic signal through coronary sinus musculature, the conduct time of coronary sinus ostium stimulation and distal coronary sinus stimulation were (44 +/- 21) ms and (41 +/- 15) ms, respectively. During stimulation delivered at lateral wall of left atrium, electronic signal was firstly observed in coronary sinus. During premature stimulation, conduction blockade of coronary sinus to left atrium was evidenced in parts of hearts, but electronic conduction of left atrium to right atrium remained stable. The ERP at the different stimulation sites of coronary sinus ostium and distal coronary sinus, posterior wall of left atrium were (122 +/- 19) ms, (114 +/- 12) ms (n = 3) and (107 +/- 17) ms (all P > 0.05).

CONCLUSIONA conduction way connecting left and right atria exists in coronary sinus which might play an important role on inducing and maintaining atrial arrhythmias under certain pathological conditions.

Animals ; Coronary Sinus ; physiology ; Dogs ; Heart Atria ; Heart Conduction System ; physiology ; Male ; Myocardium

In our studies, we have applied a novel tool, microelectrode arrays (MEA), to investigate the electrophysiological properties of murine embryonic hearts in vitro. The electrical signals were recorded from the areas of the heart adhering to the 60 MEA electrodes, being called field potentials (FPs). As an extracelluar recording, the waveform of the FP appeared similar to a reversed action potential obtained from single cell by whole cell current clamp and the FP duration was comparable with the action potential duration. To study propagation of spontaneous electrical activity, we have compared the occurrence time of FPs recorded from different electrodes. It is shown that there was already an apparent A-V delay [(50.21+/-9.7) ms] at day 9.5 post coitum (E9.5) when heart was still tubular-like and atrium and ventricle were not separated anatomically, while occurence of FP at different electrodes of ventricular area were almost synchronous. Further, we looked into the modulation of spontaneous electrical activity during cardiac development: at E9.5 of embryonic development, 1 mumol/L of isoproterenol (Iso) increased beating frequency by (34.04+/-7.31)%, shortened the A-V delay by (20.00+/-6.44) % and prolonged FP duration. In contrast, 1 mumol/L of carbachol (CCh) slowed down beating frequency by (42.32+/-5.36) %, A-V conduction by (26.00+/-4.81) % and shortened FP duration; however at late stage (E16.5), the regulatory effect of Iso and CCh was strengthened. Therefore we conclude that cardiac conduction system is already established at E9.5 when the four-chambered heart is not formed yet and the regulation of spontaneous activity by sympathetic and para-sympathetic system is gradually matured during cardiac development.
Action Potentials ; physiology ; Animals ; Electrophysiological Phenomena ; Fetal Heart ; physiology ; Heart Conduction System ; embryology ; physiology ; In Vitro Techniques ; Mice ; Microelectrodes

Objective: Explore the relationship between tip of the left bundle branch pacing lead and anatomic location of left bundle branch as well as the mechanism of left bundle branch current of injury. To clarify the clinical value of left bundle branch current of injury during operation. Methods: The pacing leads were implanted in the hearts of two living swines. Intraoperative electrophysiological study confirmed that the left bundle branch or only the deep left ventricular septum was captured at low output. Immediately after operation, the gross specimen of swine hearts was stained with iodine to observe the gross distribution of His-purkinje conduction system on the left ventricular endocardium and its relationship with the leads. Subsequently, the swine hearts were fixed with formalin solution, and the pacing leads were removed after the positions were marked. The swine hearts were then sectioned and stained with Masson and Goldner trichrome, and the relationship between the anatomic location of the conduction system and the tip of the lead was observed under a light microscope. Results: After iodine staining of the specimen, the His-purkinje conduction system was observed with the naked eye in a net-like distribution, and the lead tip was screwed deeply and fixed in the left bundle branch area of the left ventricular subendocardium in the ventricular septum. Masson and Goldner trichrome staining showed that left bundle branch pacing lead directly passed through the left bundle branch when there was left bundle branch potential with left bundle branch current of injury, while it was not directly contact the left bundle branch when there was left bundle branch potential without left bundle branch current of injury. Conclusion: The left bundle branch current of injury observed on intracardiac electrocardiogram during His-purkinje conduction system pacing suggests that the pacing lead directly contacted the conduction bundle or its branches, therefore, the captured threshold was relatively low. Left bundle branch current of injury can be used as an important anatomic and electrophysiological evidence of left bundle branch capture.
Animals ; Swine ; Bundle of His/physiology* ; Ventricular Septum ; Cardiac Pacing, Artificial ; Heart Conduction System ; Electrocardiography ; Iodine

Objective: Explore the relationship between tip of the left bundle branch pacing lead and anatomic location of left bundle branch as well as the mechanism of left bundle branch current of injury. To clarify the clinical value of left bundle branch current of injury during operation. Methods: The pacing leads were implanted in the hearts of two living swines. Intraoperative electrophysiological study confirmed that the left bundle branch or only the deep left ventricular septum was captured at low output. Immediately after operation, the gross specimen of swine hearts was stained with iodine to observe the gross distribution of His-purkinje conduction system on the left ventricular endocardium and its relationship with the leads. Subsequently, the swine hearts were fixed with formalin solution, and the pacing leads were removed after the positions were marked. The swine hearts were then sectioned and stained with Masson and Goldner trichrome, and the relationship between the anatomic location of the conduction system and the tip of the lead was observed under a light microscope. Results: After iodine staining of the specimen, the His-purkinje conduction system was observed with the naked eye in a net-like distribution, and the lead tip was screwed deeply and fixed in the left bundle branch area of the left ventricular subendocardium in the ventricular septum. Masson and Goldner trichrome staining showed that left bundle branch pacing lead directly passed through the left bundle branch when there was left bundle branch potential with left bundle branch current of injury, while it was not directly contact the left bundle branch when there was left bundle branch potential without left bundle branch current of injury. Conclusion: The left bundle branch current of injury observed on intracardiac electrocardiogram during His-purkinje conduction system pacing suggests that the pacing lead directly contacted the conduction bundle or its branches, therefore, the captured threshold was relatively low. Left bundle branch current of injury can be used as an important anatomic and electrophysiological evidence of left bundle branch capture.
Animals ; Swine ; Bundle of His/physiology* ; Ventricular Septum ; Cardiac Pacing, Artificial ; Heart Conduction System ; Electrocardiography ; Iodine

OBJECTIVETo precisely visualize cardiac anatomic structures and simultaneously depict electro-mechanical events for the purpose of precise underblood intervention.

METHODSIntracardiac high-resolution tissue Doppler imaging was used to map real time myocardial contractions in response to electrical activation within the anatomic structure of the cardiac conductive system using a canine open-chest model.

RESULTSThe detailed inner anatomic structure of the cardiac conductive system at different sites (i.e., sino-atrial, atrial wall, atrial-ventricular node and ventricular wall) with the inside onset and propagation of myocardial velocity and acceleration induced by electrical activation was clearly visualized and quantitatively evaluated.

CONCLUSIONThe simultaneous single modality visualization of the anatomy, function and electrical events of the cardiac conductive system will foster target pacing and precision ablation.

Animals ; Dogs ; Echocardiography, Doppler ; Electrocardiography ; Heart Conduction System ; diagnostic imaging ; physiology ; Myocardial Contraction ; Sinoatrial Node ; diagnostic imaging ; physiology

BACKGROUNDBoth early repolarization and altered heart rate profile are associated with sudden death. In this study, we aimed to demonstrate an association between early repolarization and heart rate profile during exercise.

METHODSA total of 84 subjects were included in the study. Comparable 44 subjects with early repolarization and 40 subjects with normal electrocardiogram underwent exercise stress testing. Resting heart rate, maximum heart rate, heart rate increment and decrement were analyzed.

RESULTSBoth groups were comparable for baseline characteristics including resting heart rate. Maximum heart rate, heart rate increment and heart rate decrement of the subjects in early repolarization group had significantly decreased maximum heart rate, heart rate increment and heart rate decrement compared to control group (all P < 0.05). The lower heart rate increment (< 106 beats/min) and heart rate decrement (< 95 beats/min) were significantly associated with the presence of early repolarization. After adjustment for age and sex, the multiple-adjusted OR of the risk of presence of early repolarization was 2.98 (95%CI 1.21-7.34) (P = 0.018) and 7.73 (95%CI 2.84-21.03) (P < 0.001) for the lower heart rate increment and heart rate decrement compared to higher levels, respectively.

CONCLUSIONSSubjects with early repolarization have altered heart rate profile during exercise compared to control subjects. This can be related to sudden death.

Adult ; Autonomic Nervous System ; physiology ; Case-Control Studies ; Electrocardiography ; Exercise ; physiology ; Exercise Test ; Female ; Heart Conduction System ; physiopathology ; Heart Rate ; Humans ; Male

On the basis of mammalian ventricular action potential model Noble98, and with the use of Runge-Kutta for solution, the Wenckebach periodicity phenomenon, the transmural heterogeneity of the ventricular myocardium and its rate dependence are studied. The results indicate that these inherent properties may, lead to temporal-space disorganized in the normal heart,and may become the underlying factors for arrhythmias. At the same time, in this study are established the basic methods for quantitative cellular electrophysiology which is essential for future studies on the mechanism of arrhythmia.
Action Potentials ; physiology ; Arrhythmias, Cardiac ; physiopathology ; Computer Simulation ; Electrophysiology ; Heart Conduction System ; physiology ; Heart Ventricles ; Humans ; Ion Channels ; metabolism ; Models, Cardiovascular ; Myocytes, Cardiac ; physiology

PURPOSETo evaluate and compare the effects of heart rate on conduction velocity in the cavotricuspid isthmus (CTI) and septum in patients with and without typical atrial flutter (AF) using electro-anatomic mapping (EAM) of the right atrium (RA).

METHODSTen patients (age 53+/-10 yrs, 7M/3F) with AF and 13 patients (age 51+/-11 yrs, 5M/8F) with atrioventricular nodal reentrant tachycardia (AVNRT) underwent conventional electrophysiological study, electro-anatomic mapping and radiofrequency ablation. Using EAMs obtained during coronary sinus pacing at pacing cycle length (PCL) 600 ms, 400 ms, and 300 ms, we evaluated conduction velocities in the CTI and septum of RA in 10 patients with AF and compared EAMs to 13 patients with AVNRT to determine whether the conduction slowing required to maintain AFL was related to changes in volume alone or altered RA electrophysiology.

RESULTSConduction velocities in CTI and septum were significantly slower at all PCL when AF was compared to AVNRT (*P<0.05). Additionally, in the AF group, septal conduction velocities were slower at PCL 600 ms and 400 ms, but not at 300 ms compared to CTI (*P<0.05). In AF, during PCL 300, conduction in CTI slowed significantly compared to PCL 600 and 400 ms such that there was no difference between CTI and septum at PCL 300.

CONCLUSIONSThere is slower conduction in the septum compared to the CTI in all patients. However, in patients with AF, there is significant slowing of conduction in the CTI and septum as well as decremental rate-dependent slowing of conduction in the CTI. These findings indicate that in addition to RA enlargement, changes in atrial electrophysiology distinguish AF patients from patients with AVNRT.

Adult ; Atrial Flutter ; physiopathology ; Female ; Heart Atria ; physiopathology ; Heart Conduction System ; physiopathology ; Heart Rate ; physiology ; Humans ; Male ; Middle Aged ; Tachycardia, Atrioventricular Nodal Reentry ; physiopathology ; Tricuspid Valve ; physiopathology

UNLABELLEDForty SD rats were divided into 5 groups: control group, SP groups (5 microg/kg,10 microg/kg, 20 microg/kg) and spantide II plus SP group. An analysis of heart rate variability (HRV) was used to detect the changes of HRV parameters before and after intravenous injection of SP in order to investigate the effect of substance P on cardiac autonomic nervous function and the corresponding mechanism.

RESULTS(1) There were significant differences in most HRV parameters for the three different doses of SP. Mean heart period (MHP), absolute power of ultra-low frequency and high frequency band (APU, APH), total power (TPV) and ratio of power in ultra-low to high frequency band (RUH) increased, while mean heart rate (MHR) and chaos intensity (HCC) decreased during the 30 minutes. Each peak amplitude of HRV parameters went higher and showed up ahead of the upward doses of SP. (2) Significant change was seen in each of the parameters between spantide II plus SP group and high-dose SP group. These data idicate that, after intravenous injection of different doses of SP, both cardiac sympathetic nervous system activity and parasympathetic nervous system activity increase, and the function of cardiac autonomic nervous becomes instable and unbalanced. The effect of SP may be dose dependent, and it is possibly mediated by neurokinin-1(NK-1) receptor.

Animals ; Autonomic Nervous System ; drug effects ; physiology ; Female ; Heart Conduction System ; drug effects ; physiology ; Heart Rate ; drug effects ; physiology ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Neurokinin-1 ; physiology ; Substance P ; pharmacology

Arrhythmia, Sinus ; physiopathology ; Arrhythmias, Cardiac ; physiopathology ; surgery ; Atrioventricular Node ; anatomy & histology ; physiology ; Catheter Ablation ; Electrophysiologic Techniques, Cardiac ; Electrophysiology ; Heart ; anatomy & histology ; physiology ; Heart Atria ; anatomy & histology ; Heart Conduction System ; physiology ; Humans ; Models, Cardiovascular ; Wolff-Parkinson-White Syndrome ; physiopathology