The effects of single premature stimuli on automatic and triggered rhythms in isolated canine Purkinje fibers.

We studied the effects of single premature stimuli on automatic and triggered rhythms occurring in preparations of isolated canine Purkinje fibers. Preparations were made from false tendons, the subendocardial right bundle branch, and infarct zone Purkinje fibers 24 hr after occlusion of the left anterior descending coronary artery, and were studied by standard microelectrode techniques. Single premature impulses almost always produced reset of automatic rhythms, whether the pacemaker had a low (less than -60 mV), intermediate (-61 to -70 mV), or high (greater than -70 mV) maximum diastolic potential. In contrast, single premature impulses imposed on triggered rhythms sometimes were found to alter these rhythms; often, early premature impulses (i.e., during phase 3) resulted in either a shortened first return cycle or a short period of arrest of the rhythm. The results of this study indicate that it may be possible to design simple electrophysiologic tests using single premature stimuli to determine whether an arrhythmia is being caused by an automatic focus or by triggered activity.