Dispersion of ventricular activation and refractoriness in patients with idiopathic dilated cardiomyopathy

[摘要] Sudden death, primarily from ventricular arrhythymias, accounts for up to 50% of deaths among patients with congestive heart failure.(1) The pathophysiologic basis for this high prevalence of sudden death remains poorly understood. Recently, prolongation of the action potential duration has been reported in myocardial cells and tissue isolated from failing animal and human hearts.(2,3) Inhomogeneous prolongation of the action potential can predispose to increased dispersion of ventricular recovery, which may provide a substrate for ventricular arrhythmias Abnormalities of cardiac conduction may exaggerate the dispersion of recovery and contribute to vulnerability to arrhythmias.(6) We hypothesized that the electrophysiologic substrate in patients with an idiopathic dilated cardiomyopathy (LDC) is characterized by increased conduction times and refractoriness, resulting in prolonged total recovery times (TRT). The purpose of our study was to test this hypothesis by comparing the rates and spatial dispersion of ventricular activation and refractoriness in IDC patients and controls.

[发布日期] 1997-04-01