Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Oct 2002
Comparative StudyUtility of exit block for identifying electrical isolation of the pulmonary veins.
Electrical isolation of the pulmonary veins (PVs) to treat paroxysmal atrial fibrillation (AF) has been described using "entry block" as an endpoint for PV isolation. We describe a new technique for guiding PV isolation, using "exit block" out of the PV after ablation as a criterion for successful isolation. ⋯ Identification of exit block after ostial PV ablation provides a clear endpoint for electrical isolation of the PVs. Isolation of the PVs can be performed during sustained AF without the need to apply excess RF lesions. Applying a 20-minute waiting period after electrical isolation will identify reconnection in approximately 10% of PVs.
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J. Cardiovasc. Electrophysiol. · Oct 2002
Comparative StudyPostresuscitation stunning: postfibrillatory myocardial dysfunction caused by reduced myofilament Ca2+ responsiveness after ventricular fibrillation-induced myocyte Ca2+ overload.
Resuscitation from ventricular fibrillation (VF), particularly from prolonged VF, frequently is complicated by postfibrillatory myocardial dysfunction (postresuscitation stunning). We tested whether this dysfunction can be caused by reduced myofilament Ca2+ responsiveness after VF-induced myocyte Ca2+ overload. We also tested whether electrical defibrillation shocks contribute to this dysfunction. ⋯ Postfibrillatory myocardial dysfunction can be caused by reduced myofilament Ca2+ responsiveness after VF-induced myocyte Ca2+ overload. Electrical defibrillation shocks (up to 15 J/g wet heart weight), however, do not significantly contribute to this dysfunction. Our findings suggest that early additional therapy targeting intracellular Ca2+ overload may normalize myocyte Ca2+ and partially prevent postresuscitation stunning.