© 1999 by European Society of Cardiology
Copyright © 1999, European Society of Cardiology
Current status of monophasic action potential recording: theories, measurements and interpretations
Cardiology Divisions of the Veteran Affairs and Georgetown University Medical Center, 50 Irving Street, NW, Washington, DC 20422, USA
* Tel.: +202-745-8398; fax: +202-745-8473; e-mail: mfranz@washington.va.gov
Received 6 February 1998; accepted 19 August 1998
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1 Introduction |
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Monophasic action potentials (MAPs) are extracellularly recorded wave forms that, under optimal conditions, can reproduce the repolarization time course of transmembrane action potentials (TAPs) with high fidelity [1–3]. While TAP recordings require the impalement of an individual cardiac cell by a glass-microelectrode and therefore generally are limited to in vitro preparations, MAPs can be recorded from the endocardium and epicardium of the in situ beating heart, including that of human subjects. MAP recordings therefore are suitable for studying the characteristics of local myocardial electrophysiology, especially of repolarization, in the clinical setting. This has made MAP recordings an important bridge between basic and clinical electrophysiology in multiple areas of arrhythmia research [4].
Despite the growing use of the MAP recording method, there still is surprisingly little hard data on the exact mechanism by which MAPs are created and recorded. New methods for recording MAPs recently have been proposed, and
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2 Brief history of MAP recording techniques |
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2.1 The ‘injury’ method
2.2 The ‘contact’ electrode method
2.3 Genesis of the MAP: old and new theories
2.4 The ‘Schütz-hypothesis’ on injury potentials
2.5 The ‘volume conductor’ hypothesis
2.6 MAP genesis by the contact electrode method
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3 Different versus indifferent electrode: which is which and which one records the MAP? |
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3.1 Unipolar MAP recordings
3.2 ‘Close-bipolar’ MAP recordings
3.3 Field of view of MAP recordings
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4 How accurate are MAP recordings compared to transmembrane action potentials? |
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4.1 MAP amplitude and resting potential
4.2 Repolarization time course
4.3 Upstroke velocity
4.4 Upstroke and phase 1 morphology
4.5 Afterdepolarizations
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5 Movement artifacts |
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5.1 Mechanoelectrical feedback
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6 Measurement and analysis of MAP recordings |
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6.1 Determining the MAP duration
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7 Simultaneous measurement of MAP duration and refractory period at the same site |
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8 Are intramural MAP recordings possible? |
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8.1 Are chronic MAP recordings possible?
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9 New avenues for MAP recordings |
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9.1 MAP recordings as a measure of myocardial viability
9.2 MAP recordings for monitoring radiofrequency energy (RF) ablation
9.3 MAP recordings for monitoring myocardial drug absorption
9.4 MAP recordings during atrial and ventricular fibrillation
9.5 MAP recordings as a means of elucidating the mechanism of torsade de pointes arrhythmias
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10 Conclusion |
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