{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T16:27:36Z","timestamp":1715531256041},"reference-count":24,"publisher":"Wiley","issue":"P1","license":[{"start":{"date-parts":[[2006,6,30]],"date-time":"2006-06-30T00:00:00Z","timestamp":1151625600000},"content-version":"vor","delay-in-days":6389,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[1989,1]]},"abstract":"<jats:p>An asymmetric biphasic pulse which stimulates the heart and neutralizes the poststimulation polarization at the electrode\u2010myocardial interface permitting the recording of the evoked endocardial response (EER) up to approximately 1 ms poststimulation with the same electrode used for stimulation is described. Using this mode of cardiac stimulation in 20 dogs the effects on the EER of increasing heart rate and antiarrhythmic drugs, procainamide (PA) and N\u2010acetylpro\u2010cainamide (NAPA), were studied. EERs were recorded during bipolar and unipolar pacing rates of 120, 150, and 200\/min before and during a five step PA or NAPA infusion which resulted in progressively increasing PA and NAPA plasma concentrations (Cps), 1.7 \u2014 32.5 mg\/l for PA and 8.1 \u2014 116.1 mg\/l for NAPA.<\/jats:p><jats:p>The effects of progressively increasing heart rates were: The T wave amplitude and QS area increased with increases in rate; during pacing at 120, 150, and 200\/min, the T wave amplitudes were 7.6 \u00b1 2.3, 8.2 \u00b1 2.1, and 9.8 \u00b1 2.5 mV and the QS areas were 905 \u00b1 204, 995 \u00b1 199, and 1101 \u00b1 231 mVms. The QT interval and QST area decreased with increases in rate; during pacing at 120, 150, and 200\/min, the QT intervals were 265 \u00b1 61, 249 \u00b1 57, and 226 \u00b1 52 ms and the QST areas were 288 \u00b1 198, 221 \u00b1 154, and 154 \u00b1 52 mVms. The effects of the antiarrhythmic drugs, PA and NAPA, on the EER were: PA prolonged both the QS duration and QT interval at low Cp (type Ia antiarrhythmic drug property); at a therapeutic PA Cp of 15.0 \u00b1 0.2 mg\/I and a heart rate of 120\/min the percent increase of the QS duration was 12 \u00b1 4% (P = 0.001) and that of the QT interval was 20 \u00b1 6% (P &lt; 0.001). The prolongation of the QS duration by PA was rate dependent, the faster the rate the greater the prolongation. NAPA prolonged the QT interval at low Cp, while the QS duration was not significantly effected at low or therapeutic Cps (type III antiarrhythmic drug property); at a therapeutic NAPA Cp of 15.9 \u00b1 1.6 mg\/l and a heart rate of 120\/min the percent increase of the QS duration was 1\u00b1 1% (NS) and that of the QT interval was 13 \u00b1 9% (P = 0.018). Our results show that the use of an asymmetric biphasic pulse allows for pacing and recording of an EER, QS and T waves, with a single electrode. This pacing and sensing system permits the rapid assessment of heart rate and antiarrhythmic drug effect on the myocardium.<\/jats:p>","DOI":"10.1111\/pace.1989.12.p1.52","type":"journal-article","created":{"date-parts":[[2017,1,13]],"date-time":"2017-01-13T08:38:46Z","timestamp":1484296726000},"page":"52-64","source":"Crossref","is-referenced-by-count":5,"title":["Rapid Assessment of Rate and Antiarrhythmic Drug Effect on the Myocardium Using Asymmetric Biphasic Pulse Stimulation"],"prefix":"10.1111","volume":"12","author":[{"given":"Tetsushi","family":"Furukawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Herscovici","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tushar","family":"Desai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Sampsell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Nogami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuo","family":"Moroe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Rozanski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Lister","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,6,30]]},"reference":[{"key":"e_1_2_1_2_1","volume-title":"Biphasic cardiac pacer. 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