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Titolo:
Simultaneous in utero assessment of AV nodal and ventricular electrophysiologic parameters in the fetal sheep heart
Autore:
Kirchhof, P; Kohl, T; Eckardt, L; Gogarten, W; Asfour, B; Witteler, R; Reckers, J; Marcus, AE; VanAken, H; Scheld, HH; Vogt, J; Borggrefe, M; Breithardt, G; Haverkamp, W;
Indirizzi:
Univ Kliniken Munster, Med Klin & Poliklin, D-48129 Munster, Germany Univ Kliniken Munster Munster Germany D-48129 , D-48129 Munster, Germany Univ Munster, Dept Pediat Cardiol, D-48129 Munster, Germany Univ Munster Munster Germany D-48129 t Cardiol, D-48129 Munster, Germany Univ Munster, Dept Cardiothorac & Vasc Surg, D-48129 Munster, Germany UnivMunster Munster Germany D-48129 Vasc Surg, D-48129 Munster, Germany Univ Munster, Dept Anesthesiol, D-48129 Munster, Germany Univ Munster Munster Germany D-48129 esthesiol, D-48129 Munster, Germany Univ Munster, Dept Gynecol & Obstet, D-48129 Munster, Germany Univ Munster Munster Germany D-48129 & Obstet, D-48129 Munster, Germany
Titolo Testata:
BASIC RESEARCH IN CARDIOLOGY
fascicolo: 3, volume: 96, anno: 2001,
pagine: 251 - 257
SICI:
0300-8428(200105/06)96:3<251:SIUAOA>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
LONG-QT SYNDROME; PULSE WIDTH; ECHOCARDIOGRAPHY; REPOLARIZATION; TACHYCARDIAS; STIMULATION; DISPERSION; DIAGNOSIS; TOOL;
Keywords:
electrophysiology; fetus; differential diagnosis; supraventricular tachycardia; pacing; animal model;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Kirchhof, P Univ Kliniken Munster, Med Klin & Poliklin, Albert Schweitzer Str 33, D-48129 Munster, Germany Univ Kliniken Munster Albert Schweitzer Str 33 Munster Germany D-48129
Citazione:
P. Kirchhof et al., "Simultaneous in utero assessment of AV nodal and ventricular electrophysiologic parameters in the fetal sheep heart", BAS R CARD, 96(3), 2001, pp. 251-257

Abstract

Background Fetal tachyarrhythmias are usually of supraventricular origin. To investigate whether specific electrophysiologic properties of the fetal heart contribute to this preponderance by either favoring supraventricular tachycardias or by rendering ventricular tachycardias unlikely, we measuredfetal electrophysiologic parameters in utero using transuterine fetal transesophageal electrocardiograms in fetal sheep. Since overdrive pacing may help to establish the mechanism of an arrhythmia and may be used to treat fetal tachycardias, different modes of transesophageal pacing in utero were also assessed. Methods and results Decapolar electrophysiology catheters were fetoscopically inserted into the esophagus of 9 fetal sheep (pregnancy duration 94 - 105 days, term = 145 days). Electrocardiograms were recorded simultaneously from all adjacent bipoles and from two pacing wires sutured onto the fetal shoulders. Pacing was attempted either via two adjacent electrodes of the intraesophageal catheter or via the most distal and most proximal electrode. Fetal cycle length, PQ, and QT intervals were close to (approx. 75 %), butfetal QRS duration was < 20 % of maternal values, thus shifting the relation between activation and repolarization towards longer excitation wave lengths. Fetal QT dispersion was small (less than or equal to 10 ms). Atrial pacing was achieved in all fetuses using distant electrodes, and with lower thresholds when compared to closely spaced bipolar electrodes (p < 0.05). Conclusions (I) An altered relation between ventricular activation and repolarization and a low dispersion of ventricular repolarization may protect the fetal heart against ventricular reentrant tachycardias. (II) Relatively normal fetal AV nodal conduction delay already provides one of the prerequisites for supraventricular reentrant tachycardias involving the AV node at this stage of fetal development. (III) High-rate esophageal Racing of the fetal atria is best achieved using widely spaced bipolar pacing electrodes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 10:43:42