Editorial
Ischaemia, action potentials, and refractoriness
| The first 150 words of the full text of this article appear below. |
The
study by Sutton and colleagues in this issue is the first to measure in
humans the changes in the left ventricular refractory period and the
duration of the ventricular monophasic action potential during the
first minutes of acute ischaemia.1 As the authors mention,
the experimental data on this subject are rather confusing. Most
studies report on a shortening of the refractory period, but
lengthening, shortening followed by lengthening, and lengthening followed by shortening have been reported as well. The classical method
to determine refractory period duration is to pace the heart with a
train of regular stimuli, and to introduce after every eighth to 10th
basic stimulus a premature stimulus that is stronger than the basic
stimulus. The shortest coupling interval of the premature stimulus that
results in a propagated response is then defined as the refractory
period at the site of stimulation. The discrepancies between the
various experimental
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