Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome. / Rivaud, Mathilde R; Bayer, Jason D; Cluitmans, Matthijs; van der Waal, Jeanne; Bear, Laura R; Boukens, Bastiaan J; Belterman, Charly; Gottlieb, Lisa; Vaillant, Fanny; Abell, Emma; Dubois, Remi; Meijborg, Veronique M F; Coronel, Ruben.

In: Heart Rhythm, Vol. 18, No. 2, 02.2021, p. 278-287.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Rivaud, MR, Bayer, JD, Cluitmans, M, van der Waal, J, Bear, LR, Boukens, BJ, Belterman, C, Gottlieb, L, Vaillant, F, Abell, E, Dubois, R, Meijborg, VMF & Coronel, R 2021, 'Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome', Heart Rhythm, vol. 18, no. 2, pp. 278-287. https://doi.org/10.1016/j.hrthm.2020.09.020

APA

Rivaud, M. R., Bayer, J. D., Cluitmans, M., van der Waal, J., Bear, L. R., Boukens, B. J., Belterman, C., Gottlieb, L., Vaillant, F., Abell, E., Dubois, R., Meijborg, V. M. F., & Coronel, R. (2021). Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome. Heart Rhythm, 18(2), 278-287. https://doi.org/10.1016/j.hrthm.2020.09.020

Vancouver

Rivaud MR, Bayer JD, Cluitmans M, van der Waal J, Bear LR, Boukens BJ et al. Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome. Heart Rhythm. 2021 Feb;18(2):278-287. https://doi.org/10.1016/j.hrthm.2020.09.020

Author

Rivaud, Mathilde R ; Bayer, Jason D ; Cluitmans, Matthijs ; van der Waal, Jeanne ; Bear, Laura R ; Boukens, Bastiaan J ; Belterman, Charly ; Gottlieb, Lisa ; Vaillant, Fanny ; Abell, Emma ; Dubois, Remi ; Meijborg, Veronique M F ; Coronel, Ruben. / Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome. In: Heart Rhythm. 2021 ; Vol. 18, No. 2. pp. 278-287.

Bibtex

@article{deb1e7d2197b4289b23dd1099f742690,
title = "Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome",
abstract = "BACKGROUND: Torsades de pointes arrhythmia is a potentially lethal polymorphic ventricular tachyarrhythmia (pVT) in the setting of long QT syndrome. Arrhythmia susceptibility is influenced by risk factors modifying repolarization.OBJECTIVE: The purpose of this article was to characterize repolarization duration and heterogeneity in relation to pVT inducibility and maintenance.METHODS: Sotalol was infused regionally or globally in isolated Langendorff blood-perfused pig hearts (N = 7) to create repolarization time (RT) heterogeneities. Programmed stimulation and epicardial activation and repolarization mapping were performed. The role of RT (heterogeneities) was studied in more detail using a computer model of the human heart.RESULTS: pVTs (n = 11) were inducible at a critical combination of RT and RT heterogeneities. The pVT cycle lengths were similar in the short and long RT regions. Short-lasting pVTs were maintained by focal activity while longer-lasting pVTs by reentry wandering along the interface between the 2 regions. Local restitution curves from the long and short RT regions crossed. This was associated with T-wave inversion at coupling intervals at either side of the crossing point. These experimental observations were confirmed by the computer simulations.CONCLUSION: pVTs are inducible within a critical range of RT and RT heterogeneities and are maintained by reentry wandering along the repolarization gradient. Double potentials localize at the core of the reentrant circuit and reflect phase singularities. RT gradient and T waves invert with short-coupled premature beats in the long RT region as a result of the crossing of the restitution curves allowing reentry initiation.",
keywords = "Action Potentials/physiology, Animals, Disease Models, Animal, Electrocardiography, Heart Conduction System/physiopathology, Heart Rate/physiology, Long QT Syndrome/etiology, Swine, Torsades de Pointes/complications",
author = "Rivaud, {Mathilde R} and Bayer, {Jason D} and Matthijs Cluitmans and {van der Waal}, Jeanne and Bear, {Laura R} and Boukens, {Bastiaan J} and Charly Belterman and Lisa Gottlieb and Fanny Vaillant and Emma Abell and Remi Dubois and Meijborg, {Veronique M F} and Ruben Coronel",
note = "Copyright {\textcopyright} 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.",
year = "2021",
month = feb,
doi = "10.1016/j.hrthm.2020.09.020",
language = "English",
volume = "18",
pages = "278--287",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier",
number = "2",

}

RIS

TY - JOUR

T1 - Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome

AU - Rivaud, Mathilde R

AU - Bayer, Jason D

AU - Cluitmans, Matthijs

AU - van der Waal, Jeanne

AU - Bear, Laura R

AU - Boukens, Bastiaan J

AU - Belterman, Charly

AU - Gottlieb, Lisa

AU - Vaillant, Fanny

AU - Abell, Emma

AU - Dubois, Remi

AU - Meijborg, Veronique M F

AU - Coronel, Ruben

N1 - Copyright © 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

PY - 2021/2

Y1 - 2021/2

N2 - BACKGROUND: Torsades de pointes arrhythmia is a potentially lethal polymorphic ventricular tachyarrhythmia (pVT) in the setting of long QT syndrome. Arrhythmia susceptibility is influenced by risk factors modifying repolarization.OBJECTIVE: The purpose of this article was to characterize repolarization duration and heterogeneity in relation to pVT inducibility and maintenance.METHODS: Sotalol was infused regionally or globally in isolated Langendorff blood-perfused pig hearts (N = 7) to create repolarization time (RT) heterogeneities. Programmed stimulation and epicardial activation and repolarization mapping were performed. The role of RT (heterogeneities) was studied in more detail using a computer model of the human heart.RESULTS: pVTs (n = 11) were inducible at a critical combination of RT and RT heterogeneities. The pVT cycle lengths were similar in the short and long RT regions. Short-lasting pVTs were maintained by focal activity while longer-lasting pVTs by reentry wandering along the interface between the 2 regions. Local restitution curves from the long and short RT regions crossed. This was associated with T-wave inversion at coupling intervals at either side of the crossing point. These experimental observations were confirmed by the computer simulations.CONCLUSION: pVTs are inducible within a critical range of RT and RT heterogeneities and are maintained by reentry wandering along the repolarization gradient. Double potentials localize at the core of the reentrant circuit and reflect phase singularities. RT gradient and T waves invert with short-coupled premature beats in the long RT region as a result of the crossing of the restitution curves allowing reentry initiation.

AB - BACKGROUND: Torsades de pointes arrhythmia is a potentially lethal polymorphic ventricular tachyarrhythmia (pVT) in the setting of long QT syndrome. Arrhythmia susceptibility is influenced by risk factors modifying repolarization.OBJECTIVE: The purpose of this article was to characterize repolarization duration and heterogeneity in relation to pVT inducibility and maintenance.METHODS: Sotalol was infused regionally or globally in isolated Langendorff blood-perfused pig hearts (N = 7) to create repolarization time (RT) heterogeneities. Programmed stimulation and epicardial activation and repolarization mapping were performed. The role of RT (heterogeneities) was studied in more detail using a computer model of the human heart.RESULTS: pVTs (n = 11) were inducible at a critical combination of RT and RT heterogeneities. The pVT cycle lengths were similar in the short and long RT regions. Short-lasting pVTs were maintained by focal activity while longer-lasting pVTs by reentry wandering along the interface between the 2 regions. Local restitution curves from the long and short RT regions crossed. This was associated with T-wave inversion at coupling intervals at either side of the crossing point. These experimental observations were confirmed by the computer simulations.CONCLUSION: pVTs are inducible within a critical range of RT and RT heterogeneities and are maintained by reentry wandering along the repolarization gradient. Double potentials localize at the core of the reentrant circuit and reflect phase singularities. RT gradient and T waves invert with short-coupled premature beats in the long RT region as a result of the crossing of the restitution curves allowing reentry initiation.

KW - Action Potentials/physiology

KW - Animals

KW - Disease Models, Animal

KW - Electrocardiography

KW - Heart Conduction System/physiopathology

KW - Heart Rate/physiology

KW - Long QT Syndrome/etiology

KW - Swine

KW - Torsades de Pointes/complications

U2 - 10.1016/j.hrthm.2020.09.020

DO - 10.1016/j.hrthm.2020.09.020

M3 - Journal article

C2 - 33031961

VL - 18

SP - 278

EP - 287

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

IS - 2

ER -

ID: 396850897