title: A left ventricular epicardial to right ventricular endocardial dominant frequency gradient exists in human ventricular fibrillation.
abstract: OBJECTIVE
  We hypothesized that in patients with left ventricular dysfunction undergoing implant of a biventricular ICD, the local dominant frequency during early induced ventricular fibrillation would be higher at an epicardial left ventricular position compared to an endocardial right ventricular position.
  
  
  METHODS
  Patients undergoing implant of a biventricular ICD were studied. During ventricular fibrillation induction, bipolar electrograms were recorded from leads at an epicardial left ventricular position and an endocardial right ventricular position. Overlapping 2-s fast Fourier transforms were obtained for 6 s of ventricular fibrillation. The dominant frequency and organizational index were compared.
  
  
  RESULTS
  Thirty-four patients (20 men, age 64 ± 11 years) underwent 57 inductions of ventricular fibrillation. Eighteen patients had non-ischemic dilated cardiomyopathy and 16 had ischemic dilated cardiomyopathy. The dominant frequency was higher at a lateral epicardial left ventricular position than an apical endocardial right ventricular position in 18 patients with non-ischemic dilated cardiomyopathy (LV epicardial 5.34 ± 0.37 Hz, RV endocardial 5.09 ± 0.41 Hz, p < 0.001), but not in 16 patients with ischemic dilated cardiomyopathy (LV epicardial 4.99 ± 0.57 Hz, RV epicardial 4.87 ± 0.65 Hz, p = 0.094).
  
  
  CONCLUSIONS
  In patients with non-ischemic dilated cardiomyopathy, there is a dominant frequency gradient during early ventricular fibrillation induced at ICD testing from the lateral left ventricular epicardium to the apical right ventricular endocardium.
authors.affiliation: Temple University School of Medicine, Temple University Hospital, Philadelphia, PA 19140, USA.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Torres
authors.forename: Bindi K
authors.initials: BK
authors.lastname: Shah
authors.forename: Richard M
authors.initials: RM
authors.lastname: Greenberg
authors.forename: Florin Titus
authors.initials: FT
authors.lastname: Deger
authors.forename: Edward P
authors.initials: EP
authors.lastname: Gerstenfeld
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D015331:Cohort Studies; D017147:Defibrillators, Implantable; D017548:Echocardiography, Transesophageal / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D012016:Reference Values; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
references.citation: Heart Rhythm. 2007 Aug;4(8):1048-56
references.pmid: 17675080
references.citation: Heart Rhythm. 2006 Nov;3(11):1295-305
references.pmid: 17074635
references.citation: Pacing Clin Electrophysiol. 2002 Jul;25(7):1114-27
references.pmid: 12164454
references.citation: Circulation. 2004 Nov 16;110(20):3181-6
references.pmid: 15533867
references.citation: J Cardiovasc Electrophysiol. 2007 Jul;18(7):757-64
references.pmid: 17578346
references.citation: Circ Res. 2001 Apr 27;88(8):839-48
references.pmid: 11325877
references.citation: Circ Res. 2002 Feb 8;90(2):213-22
references.pmid: 11834715
references.citation: Circ Res. 2000 Jan 7-21;86(1):86-93
references.pmid: 10625309
references.citation: Circ Res. 2002 Aug 23;91(4):339-45
references.pmid: 12193467
references.citation: J Am Coll Cardiol. 2002 Jan 2;39(1):109-15
references.pmid: 11755295
references.citation: Circ Res. 1991 May;68(5):1204-15
references.pmid: 2018987
references.citation: Circ Res. 2004 Apr 2;94(6):836-42
references.pmid: 14764451
references.citation: Circulation. 2001 May 29;103(21):2631-6
references.pmid: 11382735
references.citation: Card Electrophysiol Rev. 2002 Dec;6(4):472-81
references.pmid: 12438831
references.citation: Heart Rhythm. 2004 May;1(1):14-23
references.pmid: 15851110
references.citation: Circulation. 2006 Aug 8;114(6):536-42
references.pmid: 16880326
references.citation: Circ Res. 2000 Mar 3;86(4):408-17
references.pmid: 10700445