Abstract 2877: A Novel Intracardiac Pacing Method to Induce and Suppress Repolarization Alternans
Mechanistic links have been advanced between repolarization alternans (RA) and the onset of ventricular tachycardia and fibrillation. Here we demonstrate a novel intracardiac pacing method to control RA. We developed a real-time pacing system capable of delivering R-wave triggered pacing pulses during the absolute refractory period. This system allows for the independent input of the pulse amplitude, pulse width, coupling interval, and triggering type (on every odd, even, or all beats) on up to two intracardiac leads. Using this system, we can deliver R-wave triggered bipolar pacing pulses in the right ventricle (RV) and induce statistically significant RA compared to baseline (p<0.05), estimated on body surface and intracardiac signals recorded from catheters in the RV, coronary sinus (CS), and left ventricle (LV). We further demonstrate the ability to induce and suppress RA by means of simultaneous triggered pacing at a secondary site in the RV (as shown in Figure⇓) or in the LV. In conclusion, this method opens the possibility of using pacing for alternans suppression and arrhythmia prevention.
This research has received full or partial funding support from the American Heart Association, Founders Affiliate (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, Vermont).