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2001 Fiscal Year Final Research Report Summary

A Study on the mechanism and treatment of verapamil-sensitive idiopathic ventricular tachycardia

Research Project

Project/Area Number 12670642
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Circulatory organs internal medicine
Research InstitutionHirosaki University

Principal Investigator

OKUMURA Ken  Hirosaki University, Department of Medicine, Professor, 医学部, 教授 (20185549)

Co-Investigator(Kenkyū-buntansha) IWASA Atsushi  Hirosaki University, Department of Medicine, Assistant Professo, 医学部, 助手 (70312486)
Project Period (FY) 2000 – 2001
Keywordsventricular tachycardia / reentry / slow conduction / verapamil / catheter ablation
Research Abstract

Verapamil-sensitive idiopathic ventricular tachycardia (VT) occurs in relatively young patients (mean age, 28 years, ranging from 15 to 61, n = 32). We previously showed that the mechanism of this VT is reentry with an excitable gap (Am J Cardiol. 1988), and there is a calcium channel-dependent, and partly depressed sodium channel-dependent slow conduction zone in the reentry circuit (Am J Cardiol. 1996). We recently reported that late diastolic potential (LDP) preceding Purkinje (PP) and local ventricular potentials (V) is recorded in the middle mterventricular septum, and the LDP recording site is on the reentry circuit since VT can be eliminated by radio frequency energy application to this site (Circulation 1999). In this study, the nature of LDP relative to the reentry circuit was further examined. During entrainment, LDP was orthodromically captured with prolongation of LDP-PP and constant V-LDP with the increase in the pacing rate. Both lidocaine (1 mg/kg) and verapamil (≦1 mg) significantly increased VT cycle length and LDP-PP. The increases in VT cycle length after the drugs significantly correlated with those in LDP-PP. Thus, a tissue showing mainly calcium channel-dependent and partly depressed sodium channel-dependent conduction is confined to the component distal to the LDP recording site (JACC 2001). The cellular mechanism for conduction in the other part of the reentry circuit remains to be investigated.

  • Research Products

    (15 results)

All Other

All Publications (15 results)

  • [Publications] Takeshi Tsuchiya, Ken Okumura et al.: "Effects of verapamil and lidcaine on two components of the reentry circuit of verapamil-sensitive idiopathic left ventricular tachycardia"J Am Colt Cardiol. 37. 1415-1421 (2001)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Ken Okumura, Takeshi Tsuchiya: "Idiopathic left ventricular tachycardia. Clinical features, mechanisms and management"Cardiac Electrophysiol Rev. 6. 61-67 (2002)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Atsushi Iwasa, Ken Okumura et al.: "Atrial activation sequence during junctional tachycardia induced bu thermal stimulation of Koch's triangle in canine blood-perfused atrioventricular node preparation"PACE (in oress). (2002)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Takao Nakano, Ken Okumura et al.: "Enhanced activity of mutant phospholipase Cδ 1protein(R257H) detected in patients with coronary artery spasm"Circulation. (in press). (2002)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 奥村 謙: "KEY WORD心臓病「心房粗動」"先端医学社. 184-185 (2001)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Okumura K, Matsuyama K, Miyagi H, Tsuchiya T, Yasue H.: "Entrainment of idiopathic ventricular tachycardia of left ventricular origin with evidence for reentry with an area of slow conduction and effect of verapamil"Am. J. Cardiol.. 62. 727-732 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Okumura K., Yamabe H., Tsuchiya T., Tabuchi T., Iwasa A., Yasue H.: "Characteristics of slow conduction zone demonstrated during entrainment of idiopathic ventricular tachycardia of left ventricular origin"Am. J. Cardiol.. 77. 379-383 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Iwasa A., Okumura K., Tabuchi T., Tsuchiya T., Tsunoda R., Matsunaga T., Tayama S., Yasue, H.: "Effects of pilsicainide and propafenone on vagally induced atrial fibrillation: role of suppressant effect in conductivity"Eur. J. Phamacol.. 31-40 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Tsuchiya T., Okumura K., Honda T., Honda T, Iwasa A., Yasue H., Tabuchi T.: "Significance of late diastolic potential preceding Purkinje potential in verapamil-sensitive idiopathic left ventricular tachycardia"Circulation. 99. 2408-2413 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Yamabe H., Okumura K., Misumi I., Fukushima H., Ueno K., Kimura Y., Hokamura Y.: "Role of bipolar mapping in localizing recurrent conduction in the isthmus early and late after ablation of flutter"J. Am. Coll Cardiol.. 33. 39-45 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Tsucniya T., Okumura K., Tabuchi T., Iwasa A., Ohguchi M., Yasue H., Honda T, Honda T., Hayasaki K.: "Atrial ectopy originating from the posteroinferior atrium during radiofrequency catherter ablation of atrioventricular nodal reentrant tachycardia"PACE. 22. 727-737 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Higtima T., Iwasa A., Sasaki S., DaitoKu K., Motomura S., OKumura K.: "Electrogram characteristics indicative of a recurrent conduction site after ablation of the inferior vena cava-tricuspid annulus isthmus. A study in the canine blood-perfused atrioventricular preparation"Jpn. Circ. J.. 64. 295-302 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Tsuchiya T., Okumura K., Honda T., Iwasa A., Ashikaga K.: "Effects of verapamil and lidocaine on two components of the reentry circuit of verapamil-sensitive idiopathic left ventricular tachycardia"J. Am. Coll Cardiol.. 37. 1415-1421 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Okumura K, Tsuchiya T.: "Idiopathic left ventricular tachycardia. Clinical features, mechanisms and managemen"Cardiac Electrophysiol. Rev.. 6. 61-67 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Iwasa A., Motomura S., Sasaki S., Daitoku M., Higuma T., Okumura K.: "Atrial activation sequence during junctional tachycardia induced by thermal stimulation of Koch's triangle in canine blood-perfused atrioventricular node preparation"PACE. (in press). (2002)

    • Description
      「研究成果報告書概要(欧文)」より

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Published: 2003-09-17  

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