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Epicardial activation and repolarization patterns in patients with right ventricular hypertrophy
P S Chen1, K M Moser, W P Dembitsky
1Division of Cardiology, UCSD Medical Center 92103.
Circulation
|January 1, 1991
Summary
Epicardial repolarization patterns in right ventricular hypertrophy show delayed right ventricular activation and nonuniform T wave morphologies. These findings support the SI model of T wave generation.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Imaging
Background:
- Chronic pulmonary thromboembolism can lead to right ventricular hypertrophy.
- Understanding epicardial repolarization is crucial for interpreting T wave generation.
Purpose of the Study:
- To map global epicardial repolarization patterns.
- To test the
Main Methods:
- Computerized mapping techniques and monophasic action potential (MAP) recording.
- Measurement of activation-recovery (A-R) intervals using the Wyatt method and an alternative method.
- Analysis of T wave morphologies and their correlation with MAP duration.
Main Results:
- Delayed right ventricular activation and absence of normal ventricular breakthrough observed.
- Nonuniform T wave morphologies: predominantly positive over the left ventricle, negative/biphasic over the right.
- An alternative method for estimating local repolarization showed equal A-R intervals across ventricles.
Conclusions:
- The right ventricle completes activation and repolarization later than the left ventricle.
- T wave morphology distribution is nonuniform, consistent with the SI model of T wave generation.
- An alternative method accurately estimates local repolarization time in right ventricular hypertrophy.