Abstract
In this issue of HeartRhythm, an unusual and very interesting contemporary review article 1 Coronel R. Janse M. Opthof T. Wilde A. Taggart P. Postrepolarization refractoriness in acute ischemia and after antiarrhythmic drug administration: action potential duration is not always an index of the refractory period. Heart Rhythm. 2012; 9: 977-982 Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar can be found. The list of authors already generates curiosity, spanning 3 generations of electrophysiologists, from pioneers of action potential measurements in large animals and in patients undergoing open heart surgery to experts in “genetic electrophysiology” in patients and mice with genetically conferred cardiomyopathies. These experts chose to review postrepolarization refractoriness and to discuss the current knowledge on postrepolarization refractoriness and its involvement in causing and preventing arrhythmias with a focus on arrhythmogenesis in the acutely ischemic heart. The review reminds us of one of the fundamental concepts in electrophysiology, the relation between refractoriness and repolarization, and how altering this relation can have pro- and antiarrhythmic effects. Postrepolarization refractoriness in acute ischemia and after antiarrhythmic drug administration: Action potential duration is not always an index of the refractory periodHeart RhythmVol. 9Issue 6PreviewAction potential duration is widely used as a measure of refractory period in ischemia. Although the end of repolarization closely corresponds to the end of refractoriness in the well-perfused, well-oxygenated myocardium, it is no longer true for the ischemic myocardium, in which the recovery of excitability lags behind full repolarization. The purpose the study was to review this phenomenon of postrepolarization refractoriness during ischemia and after application of various antiarrhythmic drugs. Full-Text PDF
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