The electrocardiogram restitution portrait quantifying dynamical electrical instability in young myocardium

Novel methods need to be developed to detect electrical instability in children. The dynamical properties of action potential restitution play an important role in the development of instability leading to arrhythmias. A new method, the Restitution Portrait (RP), was developed to visualize and quantify these properties at the action potential level. Here, we apply the RP method using the activation-recovery interval (ARI) from the ECG to detect, in vitro, repolarization abnormalities in neonatal and preadolescent rabbit myocardium with drug-induced Long QT Syndrome (LQTS Type 1 or Type 2). The ECG was recorded during programmed endocardial pacing to record the RP. The ECG RP demonstrated significant changes in dynamical restitution components during drug-induced LQTS compared to baseline. This study shows that the ECG RP may be an important noninvasive diagnostic tool for detecting electrical instability in the young.