Effects of procainamide on wave-front dynamics during ventricular fibrillation in open-chest dogs

Yvonne Y. Kwan, Wei Fan, Dustan Hough, John J. Lee, Michael C. Fishbein, Hrayr S. Karagueuzian, Peng-Sheng Chen

Research output: Contribution to journalArticle

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Abstract

Background - There is increasing evidence that both functional reentrant wave fronts and multiple wavelets are present during ventricular fibrillation (VF). However, the effects of procainamide on the characteristics of activation waves during VF are poorly understood. Methods and Results - Seven dogs were studied; six underwent subendocardial chemical ablation procedures. A plaque with 317 to 480 bipolar electrodes was sutured to the right ventricular free wall, and the patterns of activation were registered with a computerized mapping system. VF was electrically induced, and the patterns of activation were registered at baseline and during procainamide infusion (serum concentration, 9.3 ± 1.9 μg/mL). Among the six dogs that had their subendocardium ablated, reentrant wave fronts were present in 6 of the 108 runs of VF at baseline and in 6 of the 100 runs of VF during procainamide infusion. By analyzing the wave fronts, we found that the cycle length, refractory period, conduction velocity, and wavelength at baseline were 101 ± 9 ms, 54 ± 5 ms, 0.93 ± 0.21 mm/ms, and 51 ± 16 mm, respectively, and during procainamide infusion, values became 125 ± 11 ms (P <.001), 119 ± 7 ms (P <.001), 0.42 ± 0.02 mm/ms (P <.001), and 50 ± 4 mm (P = .8), respectively. The vast majority of the activation waves do not form organized reentry. These activation waves broke up more frequently at baseline than during procainamide administration. The number of activation waves was 7.25 ± 1.39 s-1 cm-2 at baseline and 4.45 ± 1.80 s-1 cm-2 during procainamide administration (P <.001). The dog without subendocardial ablation had similar results. Conclusions - Procainamide decreases the number of wavelets during VF by preventing spontaneous wave breaks. This represents a novel mechanism of antiarrhythmic drug action.

Original languageEnglish (US)
Pages (from-to)1828-1836
Number of pages9
JournalCirculation
Volume97
Issue number18
StatePublished - May 12 1998
Externally publishedYes

Fingerprint

Procainamide
Ventricular Fibrillation
Thorax
Dogs
Anti-Arrhythmia Agents
Electrodes
Serum

Keywords

  • Conduction
  • Fibrillation
  • Procainamide
  • Waves

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Kwan, Y. Y., Fan, W., Hough, D., Lee, J. J., Fishbein, M. C., Karagueuzian, H. S., & Chen, P-S. (1998). Effects of procainamide on wave-front dynamics during ventricular fibrillation in open-chest dogs. Circulation, 97(18), 1828-1836.

Effects of procainamide on wave-front dynamics during ventricular fibrillation in open-chest dogs. / Kwan, Yvonne Y.; Fan, Wei; Hough, Dustan; Lee, John J.; Fishbein, Michael C.; Karagueuzian, Hrayr S.; Chen, Peng-Sheng.

In: Circulation, Vol. 97, No. 18, 12.05.1998, p. 1828-1836.

Research output: Contribution to journalArticle

Kwan, YY, Fan, W, Hough, D, Lee, JJ, Fishbein, MC, Karagueuzian, HS & Chen, P-S 1998, 'Effects of procainamide on wave-front dynamics during ventricular fibrillation in open-chest dogs', Circulation, vol. 97, no. 18, pp. 1828-1836.
Kwan YY, Fan W, Hough D, Lee JJ, Fishbein MC, Karagueuzian HS et al. Effects of procainamide on wave-front dynamics during ventricular fibrillation in open-chest dogs. Circulation. 1998 May 12;97(18):1828-1836.
Kwan, Yvonne Y. ; Fan, Wei ; Hough, Dustan ; Lee, John J. ; Fishbein, Michael C. ; Karagueuzian, Hrayr S. ; Chen, Peng-Sheng. / Effects of procainamide on wave-front dynamics during ventricular fibrillation in open-chest dogs. In: Circulation. 1998 ; Vol. 97, No. 18. pp. 1828-1836.
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abstract = "Background - There is increasing evidence that both functional reentrant wave fronts and multiple wavelets are present during ventricular fibrillation (VF). However, the effects of procainamide on the characteristics of activation waves during VF are poorly understood. Methods and Results - Seven dogs were studied; six underwent subendocardial chemical ablation procedures. A plaque with 317 to 480 bipolar electrodes was sutured to the right ventricular free wall, and the patterns of activation were registered with a computerized mapping system. VF was electrically induced, and the patterns of activation were registered at baseline and during procainamide infusion (serum concentration, 9.3 ± 1.9 μg/mL). Among the six dogs that had their subendocardium ablated, reentrant wave fronts were present in 6 of the 108 runs of VF at baseline and in 6 of the 100 runs of VF during procainamide infusion. By analyzing the wave fronts, we found that the cycle length, refractory period, conduction velocity, and wavelength at baseline were 101 ± 9 ms, 54 ± 5 ms, 0.93 ± 0.21 mm/ms, and 51 ± 16 mm, respectively, and during procainamide infusion, values became 125 ± 11 ms (P <.001), 119 ± 7 ms (P <.001), 0.42 ± 0.02 mm/ms (P <.001), and 50 ± 4 mm (P = .8), respectively. The vast majority of the activation waves do not form organized reentry. These activation waves broke up more frequently at baseline than during procainamide administration. The number of activation waves was 7.25 ± 1.39 s-1 cm-2 at baseline and 4.45 ± 1.80 s-1 cm-2 during procainamide administration (P <.001). The dog without subendocardial ablation had similar results. Conclusions - Procainamide decreases the number of wavelets during VF by preventing spontaneous wave breaks. This represents a novel mechanism of antiarrhythmic drug action.",
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AU - Kwan, Yvonne Y.

AU - Fan, Wei

AU - Hough, Dustan

AU - Lee, John J.

AU - Fishbein, Michael C.

AU - Karagueuzian, Hrayr S.

AU - Chen, Peng-Sheng

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N2 - Background - There is increasing evidence that both functional reentrant wave fronts and multiple wavelets are present during ventricular fibrillation (VF). However, the effects of procainamide on the characteristics of activation waves during VF are poorly understood. Methods and Results - Seven dogs were studied; six underwent subendocardial chemical ablation procedures. A plaque with 317 to 480 bipolar electrodes was sutured to the right ventricular free wall, and the patterns of activation were registered with a computerized mapping system. VF was electrically induced, and the patterns of activation were registered at baseline and during procainamide infusion (serum concentration, 9.3 ± 1.9 μg/mL). Among the six dogs that had their subendocardium ablated, reentrant wave fronts were present in 6 of the 108 runs of VF at baseline and in 6 of the 100 runs of VF during procainamide infusion. By analyzing the wave fronts, we found that the cycle length, refractory period, conduction velocity, and wavelength at baseline were 101 ± 9 ms, 54 ± 5 ms, 0.93 ± 0.21 mm/ms, and 51 ± 16 mm, respectively, and during procainamide infusion, values became 125 ± 11 ms (P <.001), 119 ± 7 ms (P <.001), 0.42 ± 0.02 mm/ms (P <.001), and 50 ± 4 mm (P = .8), respectively. The vast majority of the activation waves do not form organized reentry. These activation waves broke up more frequently at baseline than during procainamide administration. The number of activation waves was 7.25 ± 1.39 s-1 cm-2 at baseline and 4.45 ± 1.80 s-1 cm-2 during procainamide administration (P <.001). The dog without subendocardial ablation had similar results. Conclusions - Procainamide decreases the number of wavelets during VF by preventing spontaneous wave breaks. This represents a novel mechanism of antiarrhythmic drug action.

AB - Background - There is increasing evidence that both functional reentrant wave fronts and multiple wavelets are present during ventricular fibrillation (VF). However, the effects of procainamide on the characteristics of activation waves during VF are poorly understood. Methods and Results - Seven dogs were studied; six underwent subendocardial chemical ablation procedures. A plaque with 317 to 480 bipolar electrodes was sutured to the right ventricular free wall, and the patterns of activation were registered with a computerized mapping system. VF was electrically induced, and the patterns of activation were registered at baseline and during procainamide infusion (serum concentration, 9.3 ± 1.9 μg/mL). Among the six dogs that had their subendocardium ablated, reentrant wave fronts were present in 6 of the 108 runs of VF at baseline and in 6 of the 100 runs of VF during procainamide infusion. By analyzing the wave fronts, we found that the cycle length, refractory period, conduction velocity, and wavelength at baseline were 101 ± 9 ms, 54 ± 5 ms, 0.93 ± 0.21 mm/ms, and 51 ± 16 mm, respectively, and during procainamide infusion, values became 125 ± 11 ms (P <.001), 119 ± 7 ms (P <.001), 0.42 ± 0.02 mm/ms (P <.001), and 50 ± 4 mm (P = .8), respectively. The vast majority of the activation waves do not form organized reentry. These activation waves broke up more frequently at baseline than during procainamide administration. The number of activation waves was 7.25 ± 1.39 s-1 cm-2 at baseline and 4.45 ± 1.80 s-1 cm-2 during procainamide administration (P <.001). The dog without subendocardial ablation had similar results. Conclusions - Procainamide decreases the number of wavelets during VF by preventing spontaneous wave breaks. This represents a novel mechanism of antiarrhythmic drug action.

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KW - Fibrillation

KW - Procainamide

KW - Waves

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