Reflexión arterial precoz y extrasistolia ventricular. Un mecanismo novel detectado por esfigmoquinetocardiografÝa / Early arterial reflexion and ventricular extrasystole. A novel mechanism detected with sphygmokinetocardiography

ABSTRACT

ANTECEDENT Through sphygmokynetocardiography (SKCG) an exploratory method that records an electrocardiographic signal, a carotid pulse (CP), and two vibriograms (kinetocardiograms) of the left ventricle (LV) recorded in the left hemithorax (anterior kinetocardiogram, AKC) and the subcostal region of left abdomen (posterior kinetocardiogram of PKC, vibrations transmitted through the hemidiaphragm) we observed a systolic precocious reflection wave (Rw) in the CP and prolongation of LV ejection time (LVET) measured in AKC or in PKC of the previous sinusal pre-extrasystolic beat (PEB) vs control beats (CB) in cases with ventricular extrasystoles (VEs). OBJECTIVE: To demonstrate whether the intervals just mentioned are associated with ventricular extrasystoles. METHOD: Sixty cases 30 with VEs, group A, and 30 without arrhythmia, group B, were studied through SKCG. The LVET and the arterial reflection index or ARI = Ta-rw/LEVT, Ta-rw = time between initial ventricular impulse to reflexive wave, were measured. RESULTS: Demography was similar in both groups. PEB had a longer LVET than the CB (291 +/- 41 vs 279 +/- 39, p < 0.01) and ARI was shorter (0.36 +/- 0.17 vs 0.58 +/- 0.21, p < 0.001). CONCLUSIONS: 1) Distention of the LV due to Rw, possibly through the well-known experimental mechanism of electromechanic feedback, is believed to underlie the arrhythmia. 2) The observation has important clinical implications.