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Related Experiment Video

Updated: Jun 5, 2026

Programmed Electrical Stimulation in Mice

Programmed Electrical Stimulation in Mice

Published on: May 26, 2010

Mapping the unseen: Programmed electrical stimulation to detect concealed conduction block.

Rongheng Liao¹, Lu Zhang¹, Paul Knops¹

¹Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.

|November 2, 2025

Summary

This summary is machine-generated.

Programmed electrical stimulation (PES) effectively unmasks conduction blocks (CBs) in the right atrium, especially when delivered perpendicular to sinus rhythm. This method reveals more severe and extensive CBs, aiding in understanding atrial fibrillation.

Keywords:

Anisotropy Atrial fibrillation Conduction abnormalities Epicardial mapping Pacing Programmed electrical stimulation Right atrium

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Area of Science:

Electrophysiology
Cardiac Arrhythmias
Cardiovascular Research

Background:

Conduction blocks (CBs) are implicated in atrial fibrillation initiation and perpetuation.
CBs can be masked due to direction or rate dependency, complicating diagnosis.

Purpose of the Study:

To investigate methods for unmasking the highest amount and most severe CB in the right atrium (RA).
To assess the impact of programmed electrical stimulation (PES) direction and frequency on CB unmasking.

Main Methods:

High-resolution epicardial mapping in 40 patients during sinus rhythm (SR) and PES.
PES delivered from four directions at varying frequencies (SR50, S2300, S2250, S2200).
Conduction block area percentage (CBA%) and severity defined by local conduction times.

Main Results:

CBA% significantly increased from 0.6% during SR to 15.4% during S2200 (P < .001).
CB severity increased from 18 ms during SR to 46 ms during S2200 (P < .001).
PES unmasked CB in 100% of patients during S2200, with the largest increase during pacing perpendicular and opposite to SR direction.

Conclusions:

Perpendicular pacing with premature stimuli is optimal for unmasking CB.
PES can reveal significant CBs and potentially reduce them in patients with complex SR activation patterns.