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Fractionated electrograms in dilated cardiomyopathy: origin and relation to abnormal conduction
J M de Bakker1, F J van Capelle, M J Janse
1Department of Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Journal of the American College of Cardiology
|April 1, 1996
Summary
Fractionated electrograms in cardiomyopathy stem from fibrous tissue, causing abnormal heart conduction. This study clarifies the link between myocardial damage and electrical signal disturbances.
Area of Science:
- Cardiovascular Electrophysiology
- Cardiac Pathology
- Myocardial Tissue Engineering
Background:
- Dilated cardiomyopathy (DCM) is associated with a high risk of ventricular tachycardias.
- Fractionated electrograms are frequently observed in patients with DCM.
Purpose of the Study:
- To investigate the origin of fractionated electrograms.
- To understand their relationship to abnormal conduction in cardiomyopathic hearts.
Main Methods:
- High-resolution electrical mapping of human and canine cardiac muscle.
- Histological examination of myocardial tissue samples.
- Artificial creation of electrical barriers in canine models.
Main Results:
- Fractionated electrograms were consistently found in affected myocardial preparations.
- Activation patterns revealed lines of block and delayed conduction around fibrous tissue.
- Both distinct, long strands and short stretches of fibrous tissue were identified as sources.
Conclusions:
- Fractionated electrograms in cardiomyopathy result from fibrous tissue infiltration.
- Abnormal conduction is caused by activation patterns around these fibrous barriers.
- Nonuniform anisotropy contributes to delayed conduction pathways.