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Subthreshold conditioning stimuli prolong human ventricular refractoriness.

J R Windle, W M Miles, D P Zipes

    The American Journal of Cardiology
    |February 15, 1986
    PubMed
    Summary
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    Subthreshold stimuli (Sc) can prolong the human right ventricular effective refractory period. This antiarrhythmic effect depends on Sc intensity and duration, not heart rate, suggesting potential therapeutic applications.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Medical Devices

    Background:

    • The effective refractory period (ERP) is crucial for preventing cardiac arrhythmias.
    • Investigating methods to modulate ERP is essential for developing new antiarrhythmic therapies.

    Purpose of the Study:

    • To determine if subthreshold stimuli (Sc) prolong the right ventricular effective refractory period (RV ERP) in humans.
    • To assess the influence of Sc current intensity, pulse duration, and heart rate on RV ERP prolongation.

    Main Methods:

    • Human subjects underwent electrophysiological testing.
    • Subthreshold stimuli (Sc) were delivered before premature stimuli to assess their effect on RV ERP.
    • Variations in Sc current intensity and pulse duration were employed, with heart rate controlled by pacing cycle lengths.

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    Main Results:

    • Sc (10 mA, 2 ms) significantly prolonged mean RV ERP from 255 ms to 277 ms (p < 0.001).
    • ERP prolongation increased with Sc current intensity (2, 5, 10 mA) and pulse duration (2, 10, 100 ms).
    • The effect of Sc on RV ERP was independent of heart rate within the tested range (pacing cycle lengths 600 and 400 ms).

    Conclusions:

    • Subthreshold stimuli effectively prolong the RV ERP in humans.
    • RV ERP prolongation is dependent on Sc current intensity and pulse duration.
    • Subthreshold stimuli show potential as a feasible antiarrhythmic therapy in select patients.