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Brief sympathetic activation precedes the development of ventricular tachycardia and ventricular fibrillation in hibernating myocardium.

Abstract：

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.

journal_name

J Electrocardiol

journal_title

Journal of electrocardiology

authors

Pizzuto MF,Valverde AM,Heavey BM,Banas MD,Michelakis N,Suzuki G,Fallavollita JA,Canty JM Jr

doi

10.1016/j.jelectrocard.2006.05.026

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

S140-5

issue

4 Suppl

eissn

0022-0736

issn

1532-8430

pii

S0022-0736(06)00124-5

journal_volume

39

pub_type

杂志文章

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