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Related Experiment Videos

Effect of subendocardial resection on sinus rhythm endocardial electrogram abnormalities

J M Miller1, G S Tyson, W C Hargrove

  • 1Temple University Hospital, Philadelphia, Pa 19140, USA.

Circulation
|May 1, 1995
PubMed
Summary

Abnormal ventricular tachycardia electrograms, including split and late components, are significantly reduced after subendocardial tissue resection. This suggests superficial endocardial cells generate these abnormal signals in patients with myocardial infarction.

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Area of Science:

  • Electrophysiology
  • Cardiology
  • Medical Devices

Background:

  • Patients with sustained ventricular tachycardia post-myocardial infarction exhibit abnormal left ventricular endocardial electrical activity.
  • Characterized by fractionated, split, and late electrograms, the precise origin of these signals remains unclear.

Purpose of the Study:

  • To investigate the source of abnormal endocardial electrograms in patients with ventricular tachycardia.
  • To determine if superficial endocardial tissue contributes to split and late electrogram components.

Main Methods:

  • Endocardial electrograms were recorded using a 20-electrode array in 18 patients before and after subendocardial tissue resection.
  • Comparisons were made on 298 electrodes (83%) to assess changes in electrogram characteristics.

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Main Results:

  • Resection significantly reduced split electrograms (from 44% to 0%) and late components (from 27% to 0%).
  • Mean electrogram amplitude increased (0.5 to 1.0 mV) due to scar removal.
  • Mean electrogram duration decreased (112 ms to 65 ms) due to loss of late and split components.

Conclusions:

  • Split and late electrogram components are generated by superficial endocardial cells.
  • These findings support the role of surviving muscle cells within scar tissue as a source of abnormal electrical activity.