Document Detail


Thoracic spinal cord stimulation reduces the risk of ischemic ventricular arrhythmias in a postinfarction heart failure canine model.
MedLine Citation:
PMID:  15956128     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Thoracic spinal cord stimulation (SCS) is a promising therapy in treating refractory angina. This study was designed to investigate SCS with regard to the risk of arrhythmias during myocardial ischemia and its cardiac electrophysiological effects. METHODS AND RESULTS: We studied 22 dogs with healed anterior myocardial infarction (MI) and superimposed heart failure (HF) induced by rapid ventricular pacing. SCS was applied at the dorsal T1-T2 segments of the spinal cord (at 50 Hz, 0.2 ms) for 15 minutes. Transient (2-minute) myocardial ischemia was induced on 2 separate occasions (no SCS and SCS) to provoke ventricular arrhythmias (ventricular tachycardia/ventricular fibrillation; VT/VF). Ischemic episodes were separated by 90 minutes, and dogs were randomly assigned to receive SCS or no SCS before the first or second ischemic episode. SCS reduced the occurrence of VT/VF from 59% to 23% when SCS was applied during transient myocardial ischemia (odds ratio, 0.36; 95% confidence interval, 0.1626 to 0.5646; P=0.0009). SCS also decreased sinus rate by 7.5+/-14 bpm (P=0.048), increased the PR interval by 11.1+/-14.7 ms (P=0.009), and reduced systolic blood pressure by 9.8+/-13.6 mm Hg (P=0.02). CONCLUSIONS: Thoracic SCS appears to protect against ischemic VT/VF in a canine model of healed MI and HF. SCS reduced sinus rate and systolic blood pressure, changes consistent with the previously known antisympathetic effect of SCS, which may have contributed to the antiarrhythmic benefits.
Authors:
Ziad F Issa; Xiaohong Zhou; Michael R Ujhelyi; Josh Rosenberger; Deepak Bhakta; William J Groh; John M Miller; Douglas P Zipes
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-06-13
Journal Detail:
Title:  Circulation     Volume:  111     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-21     Completed Date:  2006-01-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3217-20     Citation Subset:  AIM; IM    
Affiliation:
Krannert Institute of Cardiology, Indiana University, Indianapolis, Ind 46202, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Arrhythmias, Cardiac / etiology,  prevention & control*
Blood Pressure
Disease Models, Animal
Dogs
Electric Stimulation / methods*
Heart Failure / complications
Heart Rate
Heart Ventricles
Myocardial Infarction / complications,  mortality
Myocardial Ischemia / complications*
Risk
Spinal Cord*
Thorax
Treatment Outcome
Ventricular Fibrillation / etiology,  prevention & control*

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


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