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1989 Fiscal Year Final Research Report Summary

Mechanism of idiopathic ventricular tachycardia of the left ventricular origin and the effect of antiarrhythmic agents on it. A study using an entrainment phenomenon.

Research Project

Project/Area Number 63570405
Research Category

Grant-in-Aid for General Scientific Research (C)

Allocation TypeSingle-year Grants
Research Field Circulatory organs internal medicine
Research InstitutionKumamoto University

Principal Investigator

OKUMURA Ken  Kumamoto University, University Hospital, Lecturer, 医学部・附属病院, 講師 (20185549)

Co-Investigator(Kenkyū-buntansha) MATSUYAMA Koshi  Kumamoto University, University Hospital, Assistant, 医学部・附属病院, 助手 (00190546)
Project Period (FY) 1988 – 1989
Keywordsidiopathic ventricular tachycardia / entrainment / slow conduction / antiarrhythmic drug
Research Abstract

The mechanism of idiopathic ventricular tachycardia of the left ventricular origin was studied using a tachycardia entrainment phenomenon. In 4 patients with the tachycardia, rapid ventricular pacing at rates 5-25 beats/minute faster than the tachycardia rate was performed from the right ventricular outflow tract during the tachycardia and resulted in constant fusion beats except for the last captured beat. Moreover, progressive fusion was observed with the increment of the pacing rate. Thus, the mechanism of this type of ventricular tachycardia was best explained by reentry with an excitable gap. During entrainment of the tachycardia, the conduction intervals from the pacing site (right ventricular outflow tract) to the earliest activation site during the tachycardia and to the right ventricular apex were measured: The former interval was 395-430 msec and increased with the increment of the pacing rate, while the latter one was 70-90 msec and was constant even with the increment of th … More e pacing rate. Therefore, an area of slow conduction with a property of decremental conduction was strongly suggested to be present within the reentry circuit of the tachycardia.
To examine the effect of verapamil which has been shown to be effective in interrupting the tachycardia, a small dose (1.0 mg) of the drug was administered during the tachycardia, which resulted in slowing the tachycardia rate, and entrainment study was repeated. After administration of verapamil, although the conduction interval from the pacing site to the right ventricular apex remained unchanged, that from the pacing site to the earliest activation site during the tachycardia (i.e., conduction via an area of slow conduction) was increased in al patients. This indicates that verapamil selectively suppressed the conduction through an area of slow conduction and thereby slowed the rate of the tachycardia. Tachycardia entrainment is useful to examine a selective effect of antiarrhythmic agents within the reentry circuit. Less

  • Research Products

    (13 results)

All Other

All Publications (13 results)

  • [Publications] Ken Okumura,他4名: "Entraiment of idiopathic ventricoclar tachyardia of left ventricular origin with evidence for recentry with an area of slow conduction and effect of verapamil" American Journal of Acrdiology. 62. 727-732 (1988)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Henthorn RW,Ken Okumura,他4名: "A fourth creterion for transient entrainment The electrogram equivalent to progressive fusion" Circulation. 77. 1003-1012 (1988)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Ken Okumura,他3名: "Facilitation of localized conduction block with procainamide during entrainment of susfained ventricular fachycaidia" American Heart Journal. 118. 630-632 (1989)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 奥村謙: "entrainment.リエントリ-の所見" medicina. 26. 8-10 (1989)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 奥村謙,他3名: "エントレインメント現象による慢性及復性心室性頻拍症発症機序の検討" 心電図. 9. 189-194 (1989)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 奥村謙: "エントレインメントとは何か" Pharma Medica. 7. 155-156 (1989)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 奥村謙(比江嶋一昌編集): "「Practical seminar不整脈」C-3.虚血性心疾患に伴う不整脈" 日本医事新報社, 250 (1990)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Okumura K, Henthorn RW, Epstein AE, Plumb VJ, Waldo AL: "Further observation on transient entrainment. Importance of pacing site and properties of the components of the reentry circuit." Circulation. 72. 1293 (1985)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Okumura K, Henthorn RW, Olshansky B, Waldo AL: "Entrainment of sustained ventricular tachycardia. Evidence for collision of two excitation wave fronts from two different pacing impulses." Proceedings of the International Symposium on Cardiac Arrhythmias. Excerpta Medica. 145 (1986)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Okumura K, Olshansky B, Henthorn RW, Plumb VJ, Waldo AL: "Demonstration of the presence of slow conduction during sustained ventricular tachycardia in man. Use of transient entrainment of the tachycardia." Circulation 75: 369, 1987.

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Henthorn RW, Okumura K, Olshansky B, Plumb VJ, Waldo AL: "A forth criterion for transient entrainment. The electrogram equivalent of progressive fusion." Circulation 77: 1003, 1988.

    • Description
      「研究成果報告書概要(欧文)」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, 1988.

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Okumura K, Honda T, Nishigami K, Hayasaki K: "Facilitation of localized conduction block with procainamide during entrainment of sustained ventricular tachycardia." Am Heart J 118: 630, 1989.

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

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Published: 1993-03-26  

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