Contributions of the specialized conduction system to the activation sequence in the canine pulmonary conus. Pollard, Andrew E., Kenneth W. Spitzer[grave]a, and Mary Jo Burgess[grave]a. Department of Biomedical Engineering, University of Alabama Birmingham, Birmingham, Alabama USA and Nora Eccles Harrison Cardiovascular Research and Training Institute[grave]a, The University of Utah, Salt Lake City, Utah, USA
APStracts 3:0511H, 1996.
This study was designed to characterize the relative contributions of the specialized conduction system and the myocardial architecture to the ventricular activation sequence. In animal experiments, the activation sequence within a 14 mm by 14 mm region on each surface of the pulmonary conus from isolated canine hearts was determined from electrograms recorded during ventricular drives applied at the periphery of the measurement region. Recordings were obtained simultaneously from electrode arrays mounted on the endocardium and epicardium. Activation sequences were determined before and after bathing the right ventricular cavity with a dilute Lugol/Normal Tyrode's (LNT) solution that selectively inhibited excitation of Purkinje cells. Simulations of action potential propagation in three -dimensional models (14.4 mm long by 7.2 mm wide by 3.6 mm thick) that included the major features of the mid-wall architecture were performed to aid in the interpretation of the experimental findings. During endocardial pacing (7 animals, 43 total drives), LNT application markedly prolonged the endocardial (13.7+/-1.3 msec) and epicardial (5.7+/-1.0 msec) activation sequences. However, epicardial isochrone maps constructed using electrograms recorded before LNT application showed no signs of multiple breakthrough sites, and with the exception of overall timing, closely resembled isochrone maps constructed using electrograms recorded after LNT application. During epicardial pacing (9 animal, 55 total drives), LNT application prolonged the endocardial (3.7+/-0.6 msec) and epicardial (1.9+/-0.6 msec) activation sequences much less dramatically than during endocardial pacing, suggesting a primary contribution of myocardial architecture. However, in those instances where nonuniform anisotropy slowed epicardial expansion of the depolarization wavefront, the specialized conduction system contributed to the activation sequence to a greater extent.

Received 25 October 1995; accepted in final form 1 November 1996.
APS Manuscript Number H995-5.
Article publication pending Am. J. Physiol. (Heart Circ. Physiology).
ISSN 1080-4757 Copyright 1996 The American Physiological Society.
Published in APStracts on 31 December 1996