Unipolar and bipolar electrogram characteristics of recurrent cases of idiopathic ventricular arrhythmias undergoing repeat catheter ablation.

INTRODUCTION: Activation mapping guided catheter ablation (CA) of ventricular arrhythmias (VAs) is limited in some cases when it is only relied on bipolar electrogram (EGM). We hypothesized that activation mapping with use of combined bipolar and unipolar EGM facilitates to identify the focal origin of VAs and results in reduction of recurrence rate of CA of VAs. METHODS: We analyzed the data of patients undergoing repeat ablations for idiopathic out-flow tract VAs. The EGM of the 1 st and 2 nd ablations were compared for earliest local activation time (LAT), presence of discrete potentials, and polarity reversal, unipolar potential morphology (QS or non-QS), potential amplitude and activation slope. RESULTS: Thirty-seven patients were included. The Local activation time was significantly earlier in the 2nd ablation as compared to the 1st procedure (36.90 msec vs 31.85 msec, P < 0.01). The incidence of discrete potentials and polarity reversal were similar in both procedures (51% vs 57%, P = 0.8 and 62% in both the occasions, respectively). The unipolar voltage was similar in both occasions (6.94 mV vs 7.22 mV in repeat ablations, P = 0.7). The recurrence rate (5.7%) was significantly lower with routine use of combined unipolar and bipolar EGMs, as compared to the use of bipolar EGM alone (16.7%) CONCLUSIONS: Use of both bipolar and unipolar electrograms helps in better delineation of the sites of earliest activation for effective ablation of VAs. Use of unipolar electrograms in addition to bipolar electrograms is associated with lower long term recurrence rate.

Dynamics of membrane fatty acid composition of succinic acid-producing Anaerobiospirillum succiniciproducens.

The dynamics of the membrane fatty acid composition of a succinic acid-producing bacterium, Anaerobiospirillum succiniciproducens, was studied using continuous and batch cultures. In both batch and chemostat continuous culture conditions, A. succiniciproducens grown on glucose or glycerol responded to acid stress by lowering the content of saturated fatty acids (SFAs) and increasing the content of unsaturated fatty acids (UFAs). Notably, A. succiniciproducens elongated C16:0 (SFA) and converted it to C18:1 (UFA) in the pH-uncontrolled culture, which is a common bacterial adaptation strategy to combat acid stress. Interestingly, A. succiniciproducens did not exhibit a significant increase in cyclic FA content, which is another common strategy to cope with acidic conditions.