Document Detail


Brief sympathetic activation precedes the development of ventricular tachycardia and ventricular fibrillation in hibernating myocardium.
MedLine Citation:
PMID:  16919670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hibernating myocardium develops inhomogeneity in myocardial sympathetic innervation with spontaneous sudden cardiac death (SCD) because of ventricular fibrillation (VF). The triggers and prodromal arrhythmias initiating SCD in this substrate are unknown. METHODS: Swine chronically instrumented with a proximal left anterior descending coronary artery stenosis underwent placement of an implantable telemetry unit capable of continuously recording digitized electrocardiogram and left ventricular pressure signals at 1 kHz in conscious unrestrained animals for periods of up to 5 months. RESULTS: Spontaneous SCD (n = 10) was initiated by a close-coupled premature ventricular contraction followed by ventricular tachycardia (VT) that degenerated into VF during brief sympathetic activation. Peak heart rates were similar in animals that developed SCD vs survivors (250 +/- 12 vs 261 +/- 6 bpm). Electrocardiogram evidence of ischemia preceding VT/VF occurred in only 1 animal, and there was no significant infarction. CONCLUSIONS: Spontaneous VT/VF in hibernating myocardium develops during brief sympathetic activation with only rare evidence of acute ischemia. This supports the notion that the regional remodeling accompanying hibernating myocardium may be a novel substrate for the development of SCD in chronic ischemic heart disease.
Authors:
Matthew F Pizzuto; Arturo M Valverde; Brendan M Heavey; Michael D Banas; Nickolaos Michelakis; Gen Suzuki; James A Fallavollita; John M Canty
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2006-08-21
Journal Detail:
Title:  Journal of electrocardiology     Volume:  39     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-03     Completed Date:  2006-11-09     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S140-5     Citation Subset:  IM    
Affiliation:
Center for Research in Cardiovascular Medicine, University at Buffalo, Buffalo, NY 14214, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Heart Conduction System / physiopathology*
Heart Rate
Heart Ventricles / innervation*,  physiopathology*
Myocardial Stunning / physiopathology*
Swine
Sympathetic Nervous System / physiopathology*
Tachycardia, Ventricular / physiopathology*
Ventricular Fibrillation / physiopathology*
Grant Support
ID/Acronym/Agency:
HL-55234/HL/NHLBI NIH HHS; HL-61610/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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