Distributions of paced intramyocardial velocity as a predictor of sudden arrhythmic death

A new method has been developed for investigation of the potential for ventricular arrhythmias in the cardiomyopathies. It is based on the idea that myofibrillar disarray will cause dispersion of conduction and so create one component of a reentrant substrate. One ventricular site is paced with a decremental sequence and electrograms are recorded from three other RV sites. Fractionation of the recorded electrograms are measured by determining the distribution of transitions which presumably correspond to activation of discrete fibre bundles near the stimulating electrode. The rate at which electrogram duration and length increases with premature stimulation correlates strongly with the risk of ventricular arrhythmias