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Front Cardiovasc Med. 2019 Nov 05;6:158. doi: 10.3389/fcvm.2019.00158. eCollection 2019.

Ventricular Arrhythmias in First Acute Myocardial Infarction: Epidemiology, Mechanisms, and Interventions in Large Animal Models.

Frontiers in cardiovascular medicine

Stefan Michael Sattler, Lasse Skibsbye, Dominik Linz, Anniek Frederike Lubberding, Jacob Tfelt-Hansen, Thomas Jespersen

Affiliations

  1. Department of Cardiology, Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
  2. Medical Department I, University Hospital Grosshadern, LMU Munich, Munich, Germany.
  3. Department of Exploratory Toxicology, H. Lundbeck A/S, Copenhagen, Denmark.
  4. Medical Department III, Universitätsklinikum des Saarlandes, Homburg, Germany.
  5. Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA, Australia.
  6. Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  7. Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

PMID: 31750317 PMCID: PMC6848060 DOI: 10.3389/fcvm.2019.00158

Abstract

Ventricular arrhythmia and subsequent sudden cardiac death (SCD) due to acute myocardial infarction (AMI) is one of the most frequent causes of death in humans. Lethal ventricular arrhythmias like ventricular fibrillation (VF) prior to hospitalization have been reported to occur in more than 10% of all AMI cases and survival in these patients is poor. Identification of risk factors and mechanisms for VF following AMI as well as implementing new risk stratification models and therapeutic approaches is therefore an important step to reduce mortality in people with high cardiovascular risk. Studying spontaneous VF following AMI in humans is challenging as it often occurs unexpectedly in a low risk subgroup. Large animal models of AMI can help to bridge this knowledge gap and are utilized to investigate occurrence of arrhythmias, involved mechanisms and therapeutic options. Comparable anatomy and physiology allow for this translational approach. Through experimental focus, using state-of-the-art technologies, including refined electrical mapping equipment and novel pharmacological investigations, valuable insights into arrhythmia mechanisms and possible interventions for arrhythmia-induced SCD during the early phase of AMI are now beginning to emerge. This review describes large experimental animal models of AMI with focus on first AMI-associated ventricular arrhythmias. In this context, epidemiology of first AMI, arrhythmogenic mechanisms and various potential therapeutic pharmacological targets will be discussed.

Copyright © 2019 Sattler, Skibsbye, Linz, Lubberding, Tfelt-Hansen and Jespersen.

Keywords: STEMI; acute myocardial infarction; animal models; anti-arrhythmia agents; ischemia; sudden cardiac death; ventricular arrhythmia; ventricular fibrillation

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