Document Detail


Chemical ablation of the Purkinje system causes early termination and activation rate slowing of long-duration ventricular fibrillation in dogs.
MedLine Citation:
PMID:  18586887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Endocardial mapping has suggested that Purkinje fibers may play a role in the maintenance of long-duration ventricular fibrillation (LDVF). To determine the influence of Purkinje fibers on LDVF, we chemically ablated the Purkinje system with Lugol solution and recorded endocardial and transmural activation during LDVF. Dog hearts were isolated and perfused, and the ventricular endocardium was exposed and treated with Lugol solution (n = 6) or normal Tyrode solution as a control (n = 6). The left anterior papillary muscle endocardium was mapped with a 504-electrode (21 x 24) plaque with electrodes spaced 1 mm apart. Transmural activation was recorded with a six-electrode plunge needle on each side of the plaque. Ventricular fibrillation (VF) was induced, and perfusion was halted. LDVF spontaneously terminated sooner in Lugol-ablated hearts than in control hearts (4.9 +/- 1.5 vs. 9.2 +/- 3.2 min, P = 0.01). After termination of VF, both the control and Lugol hearts were typically excitable, but only short episodes of VF could be reinduced. Endocardial activation rates were similar during the first 2 min of LDVF for Lugol-ablated and control hearts but were significantly slower in Lugol hearts by 3 min. In control hearts, the endocardium activated more rapidly than the epicardium after 4 min of LDVF with wave fronts propagating most often from the endocardium to epicardium. No difference in transmural activation rate or wave front direction was observed in Lugol hearts. Ablation of the subendocardium hastens VF spontaneous termination and alters VF activation sequences, suggesting that Purkinje fibers are important in the maintenance of LDVF.
Authors:
Derek J Dosdall; Paul B Tabereaux; Jong J Kim; Gregory P Walcott; Jack M Rogers; Cheryl R Killingsworth; Jian Huang; Peter G Robertson; William M Smith; Raymond E Ideker
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, N.I.H., Extramural     Date:  2008-06-27
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  295     ISSN:  0363-6135     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-08     Completed Date:  2008-09-25     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H883-9     Citation Subset:  IM    
Affiliation:
Volker Hall B140, 1670 Univ. Blvd., Birmingham, AL 35294-0019, USA.
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MeSH Terms
Descriptor/Qualifier:
Action Potentials
Animals
Body Surface Potential Mapping
Cardiac Pacing, Artificial
Disease Models, Animal
Dogs
Endocardium / drug effects*,  physiopathology
Iodides / pharmacology*
Purkinje Fibers / drug effects*,  physiopathology
Time Factors
Ventricular Fibrillation / physiopathology*
Grant Support
ID/Acronym/Agency:
HL-28429/HL/NHLBI NIH HHS; HL-64184/HL/NHLBI NIH HHS; HL-85370/HL/NHLBI NIH HHS; T32 HL-07457-16/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Iodides; T66M6Y3KSA/Lugol's solution
Comments/Corrections

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