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Garg V, Taylor T, Warren M, et al. β-Adrenergic stimulation and rapid pacing mutually promote heterogeneous electrical failure and ventricular fibrillation in the globally ischemic heart. Am J Physiol Heart Circ Physiol. 2015;308(9):H1155-70doi: 10.1152/ajpheart.00768.2014.
Garg, V., Taylor, T., Warren, M., Venable, P., Sciuto, K., Shibayama, J., & Zaitsev, A. (2015). β-Adrenergic stimulation and rapid pacing mutually promote heterogeneous electrical failure and ventricular fibrillation in the globally ischemic heart. American journal of physiology. Heart and circulatory physiology, 308(9), H1155-70. https://doi.org/10.1152/ajpheart.00768.2014
Garg, Vivek, et al. "β-Adrenergic stimulation and rapid pacing mutually promote heterogeneous electrical failure and ventricular fibrillation in the globally ischemic heart." American journal of physiology. Heart and circulatory physiology vol. 308,9 (2015): H1155-70. doi: https://doi.org/10.1152/ajpheart.00768.2014
Garg V, Taylor T, Warren M, Venable P, Sciuto K, Shibayama J, Zaitsev A. β-Adrenergic stimulation and rapid pacing mutually promote heterogeneous electrical failure and ventricular fibrillation in the globally ischemic heart. Am J Physiol Heart Circ Physiol. 2015 May 01;308(9):H1155-70. doi: 10.1152/ajpheart.00768.2014. Epub 2015 Feb 20. PMID: 25713306; PMCID: PMC4551128.
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Am J Physiol Heart Circ Physiol. 2015 May 01;308(9):H1155-70. doi: 10.1152/ajpheart.00768.2014. Epub 2015 Feb 20.

β-Adrenergic stimulation and rapid pacing mutually promote heterogeneous electrical failure and ventricular fibrillation in the globally ischemic heart.

American journal of physiology. Heart and circulatory physiology

Vivek Garg, Tyson Taylor, Mark Warren, Paul Venable, Katie Sciuto, Junko Shibayama, Alexey Zaitsev

Affiliations

  1. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah;
  2. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah; Department of Bioengineering, University of Utah, Salt Lake City, Utah; and.
  3. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah; Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.
  4. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah; Department of Bioengineering, University of Utah, Salt Lake City, Utah; and [email protected].

PMID: 25713306 PMCID: PMC4551128 DOI: 10.1152/ajpheart.00768.2014

Abstract

Global ischemia, catecholamine surge, and rapid heart rhythm (RHR) due to ventricular tachycardia or ventricular fibrillation (VF) are the three major factors of sudden cardiac arrest (SCA). Loss of excitability culminating in global electrical failure (asystole) is the major adverse outcome of SCA with increasing prevalence worldwide. The roles of catecholamines and RHR in the electrical failure during SCA remain unclear. We hypothesized that both β-adrenergic stimulation (βAS) and RHR accelerate electrical failure in the globally ischemic heart. We performed optical mapping of the action potential (OAP) in the right ventricular (RV) and left (LV) ventricular epicardium of isolated rabbit hearts subjected to 30-min global ischemia. Hearts were paced at a cycle length of either 300 or 200 ms, and either in the presence or in the absence of β-agonist isoproterenol (30 nM). 2,3-Butanedione monoxime (20 mM) was used to reduce motion artifact. We found that RHR and βAS synergistically accelerated the decline of the OAP upstroke velocity and the progressive expansion of inexcitable regions. Under all conditions, inexcitability developed faster in the LV than in the RV. At the same time, both RHR and βAS shortened the time to VF (TVF) during ischemia. Moreover, the time at which 10% of the mapped LV area became inexcitable strongly correlated with TVF (R(2) = 0 .72, P < 0.0001). We conclude that both βAS and RHR are major factors of electrical depression and failure in the globally ischemic heart and may contribute to adverse outcomes of SCA such as asystole and recurrent/persistent VF.

Copyright © 2015 the American Physiological Society.

Keywords: inexcitability; myocardial ischemia; optical mapping; ventricular fibrillation; β-adrenergic stimulation

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