Document Detail


Regional Cooling Facilitates Termination of Spiral-Wave Reentry through Unpinning of Rotors in Rabbit Hearts.
MedLine Citation:
PMID:  21839044     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Moderate global cooling of myocardial tissue was shown to destabilize 2-dimensional (2-D) reentry and facilitate its termination. OBJECTIVE: To test the hypothesis that regional cooling destabilizes rotors and facilitates termination of spontaneous and DC-shock-induced subepicardial reentry in isolated, endocardially ablated rabbit hearts. METHODS: Fluorescent action potential signals were recorded from 2-D subepicardial ventricular myocardium of Langendorff-perfused rabbit hearts. Regional cooling (by 5.9±1.3°C) was applied to the left ventricular anterior wall using a transparent cooling device (10 mm in diameter). RESULTS: Regional cooling during constant stimulation (2.5 Hz) prolonged the action potential duration (by 36±9%) and slightly reduced conduction velocity (by 4±4%) in the cooled region. Ventricular tachycardias (VTs) induced during regional cooling terminated earlier than those without cooling (control): VTs lasting >30 s were reduced from 17/39 to 1/61. When regional cooling was applied during sustained-VTs (>120 s), 16/33 (48%) sustained-VTs self-terminated in 12.5±5.1 s. VT termination was the result of rotor destabilization, which was characterized by unpinning, drift toward the periphery of the cooled region and subsequent collision with boundaries. The DC-shock intensity required for cardioversion of the sustained-VTs decreased significantly by regional cooling (22.8±4.1 V, n=16 vs. 40.5±17.6 V, n=21). The major mode of reentry termination by DC-shocks was phase resetting in the absence of cooling, whereas unpinning in the presence of cooling. CONCLUSION: Regional cooling facilitates termination of 2-D reentry through unpinning of rotors.
Authors:
Masatoshi Yamazaki; Haruo Honjo; Takashi Ashihara; Masahide Harada; Ichiro Sakuma; Kazuo Nakazawa; Natalia Trayanova; Minoru Horie; Jérôme Kalifa; José Jalife; Kaichiro Kamiya; Itsuo Kodama
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-9
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan; Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan.
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