Skip to main content
SpringerLink
Log in

A left ventricular epicardial to right ventricular endocardial dominant frequency gradient exists in human ventricular fibrillation

  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

We hypothesized that in patients with left ventricular dysfunction undergoing implant of a biventricular ICD, the local dominant frequency during early induced ventricular fibrillation would be higher at an epicardial left ventricular position compared to an endocardial right ventricular position.

Methods

Patients undergoing implant of a biventricular ICD were studied. During ventricular fibrillation induction, bipolar electrograms were recorded from leads at an epicardial left ventricular position and an endocardial right ventricular position. Overlapping 2-s fast Fourier transforms were obtained for 6 s of ventricular fibrillation. The dominant frequency and organizational index were compared.

Results

Thirty-four patients (20 men, age 64 ± 11 years) underwent 57 inductions of ventricular fibrillation. Eighteen patients had non-ischemic dilated cardiomyopathy and 16 had ischemic dilated cardiomyopathy. The dominant frequency was higher at a lateral epicardial left ventricular position than an apical endocardial right ventricular position in 18 patients with non-ischemic dilated cardiomyopathy (LV epicardial 5.34 ± 0.37 Hz, RV endocardial 5.09 ± 0.41 Hz, p < 0.001), but not in 16 patients with ischemic dilated cardiomyopathy (LV epicardial 4.99 ± 0.57 Hz, RV epicardial 4.87 ± 0.65 Hz, p = 0.094).

Conclusions

In patients with non-ischemic dilated cardiomyopathy, there is a dominant frequency gradient during early ventricular fibrillation induced at ICD testing from the lateral left ventricular epicardium to the apical right ventricular endocardium.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Choi, B. R., Nho, W., Liu, T., & Salama, G. (2002). Lifespan of ventricular fibrillation frequencies. Circulation Research, 91, 339–345.

    Article  CAS  PubMed  Google Scholar 

  2. Valderrabano, M., Lee, M. H., Ohara, T., Lai, A. C., Lin, S.-F., Fishbein, M. C., et al. (2001). Dynamics of intramural and transmural reentry during ventricular fibrillation in isolated swine ventricles. Circulation Research, 88, 839–848.

    Article  CAS  PubMed  Google Scholar 

  3. Valderrabano, M., Yang, J., Omichi, C., Kil, J., Lamp, S. T., Qu, Z., et al. (2002). Frequency analysis of ventricular fibrillation in swine ventricles. Circulation Research, 90, 213–222.

    Article  CAS  PubMed  Google Scholar 

  4. Zaitsev, A. V., Berenfeld, O., Mironov, S. F., Jalife, J., & Pertsov, A. M. (2000). Distribution of excitation frequencies on the epicardial and endocardial surfaces of fibrillating ventricular wall of the sheep heart. Circulation Research, 90, 408–417.

    Google Scholar 

  5. Chen, J., Mandapati, R., Berenfeld, O., Skanes, A. C., & Jalife, J. (2000). High frequency periodic sources underlie ventricular fibrillation in the isolated rabbit heart. Circulation Research, 86, 86–93.

    CAS  PubMed  Google Scholar 

  6. Nash, M. P., Mourad, A., Clayton, R. H., Sutton, P. M., Bradley, C. P., Hayward, M., et al. (2006). Evidence for multiple mechanisms in human ventricular fibrillation. Circulation, 114, 536–542.

    Article  PubMed  Google Scholar 

  7. Nanthakumar, K., Walcott, G. P., Melnick, S., Rogers, J. M., Kay, M. W., Smith, W. M., et al. (2004). Epicardial organization of human ventricular fibrillation. Heart Rhythm, 1, 14–23.

    Article  PubMed  Google Scholar 

  8. Walcott, G. P., Kay, G. N., Plumb, V. J., Smith, W. M., Rogers, J. M., Epstein, A. E., et al. (2002). Endocardial wave front organization during ventricular fibrillation in humans. Journal of the American College of Cardiology, 39, 109–115.

    Article  PubMed  Google Scholar 

  9. Lazar, S., Dixit, S., Marchlinski, F. E., Callans, D. J., & Gerstenfeld, E. P. (2004). Presence of left to right atrial frequency gradient in paroxysmal but not persistent atrial fibrillation in humans. Circulation, 110, 3181–3186.

    Article  PubMed  Google Scholar 

  10. Ng, J., Kadish, A. H., & Goldberger, J. J. (2007). Technical considerations for dominant frequency analysis. Journal of Cardiovascular Electrophysiology, 18, 757–764.

    Article  PubMed  Google Scholar 

  11. Ng, J., Kadish, A. H., & Goldberger, J. J. (2006). Effect of electrogram characteristics on the relationship of dominanat frequency to atrial activation rate in atrial fibrillation. Heart Rhythm, 3, 1295–1305.

    Article  PubMed  Google Scholar 

  12. Everett, T. H., Wilson, E. E., & Olgin, J. E. (2007). Effects of atrial fibrillation substrate and spatiotemporal organization on atrial defibrillation thresholds. Heart Rhythm, 4, 1048–1056.

    Article  PubMed  Google Scholar 

  13. Opthof, T., Ramdat Misier, A. R., Coronel, R., Vermeulen, J. T., Verberne, H. J., Frank, R. G. J., et al. (1991). Dispersion of refractoriness in canine ventricular myocardium. Circulation Research, 68, 1204–1215.

    CAS  PubMed  Google Scholar 

  14. Newton, J., Smith, W. M., & Ideker, R. E. (2004). Estimated global transmural distribution of activation rate and conduction block during porcine and canine ventricular fibrillation. Circulation Research, 94, 836–842.

    Article  CAS  PubMed  Google Scholar 

  15. Mansour, M., Mandapati, R., Berenfeld, O., Chen, J., Samie, F. H., & Jalife, J. (2001). Left-to-right gradient of atrial frequencies during acute atrial fibrillation in the isolated sheep heart. Circulation, 103, 2631–2636.

    CAS  PubMed  Google Scholar 

  16. Hsia, H. H., & Marchlinski, F. E. (2002). Characterization of the electroanatomical substrate for monomorphic ventricular tachycardia in patients with nonischemic cardiomyopathy. PACE, 25, 1114–1127.

    PubMed  Google Scholar 

  17. Hsia, H. H., & Marchlinski, F. E. (2002). Electrophysiologic studies in patients with dilated cardiomyopathy. Cardiac Electrophysiology Review, 6, 472–481.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Temple University School of Medicine, Temple University Hospital, Philadelphia, PA, USA

    Jose Luis Torres, Bindi K. Shah, Richard M. Greenberg & Florin Titus Deger

  2. University of Pennsylvania, Philadelphia, PA, USA

    Edward P. Gerstenfeld

  3. Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Edward P. Gerstenfeld

  4. Temple Heart Center, Parkinson Building 9th Floor, 3401 North Broad Street, Philadelphia, PA, 19140, USA

    Florin Titus Deger

Authors
  1. Jose Luis Torres
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bindi K. Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard M. Greenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Florin Titus Deger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Edward P. Gerstenfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Florin Titus Deger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Torres, J.L., Shah, B.K., Greenberg, R.M. et al. A left ventricular epicardial to right ventricular endocardial dominant frequency gradient exists in human ventricular fibrillation. J Interv Card Electrophysiol 29, 11–16 (2010). https://doi.org/10.1007/s10840-010-9488-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-010-9488-2

Keywords

Search

Navigation