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1 Service of Cardiology, Valencia University Clinic Hospital; Departments of 2 Electronics and 4 Physiology, Valencia University; and 3 Department of Electronic Engineering, Valencia Polytechnic University, 46010 Valencia, Spain
Because of
its electrophysiological effects, hypothermia can influence the
mechanisms that intervene in the sustaining of ventricular
fibrillation. We hypothesized that a rapid and profound reduction of
myocardial temperature impedes the maintenance of ventricular
fibrillation, leading to termination of the arrhythmia. High-resolution
epicardial mapping (series 1; n = 11) and
transmural recordings of ventricular activation (series 2;
n = 10) were used to analyze ventricular fibrillation
modification during rapid myocardial cooling in Langendorff-perfused
rabbit hearts. Myocardial cooling was produced by the injection of cold
Tyrode into the left ventricle after induction of ventricular
fibrillation. Temperature and ventricular fibrillation dominant
frequency decay fit an exponential model to arrhythmia termination in
all experiments, and both parameters were significantly correlated
(r = 0.70, P < 0.0001). Termination of
the arrhythmia occurred preferentially in the left ventricle and was
associated with a reduction in conduction velocity (
60% in left
ventricle and
54% in right ventricle; P < 0.0001)
and with activation maps predominantly exhibiting a single wave front, with evidence of wave front extinction. We conclude that a rapid reduction of temperature to <20°C terminates ventricular
fibrillation after producing an important depression in myocardial conduction.
ventricular arrhythmias; defibrillation; mapping; spectral analysis
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M. Harada, H. Honjo, M. Yamazaki, H. Nakagawa, Y. S. Ishiguro, Y. Okuno, T. Ashihara, I. Sakuma, K. Kamiya, and I. Kodama Moderate hypothermia increases the chance of spiral wave collision in favor of self-termination of ventricular tachycardia/fibrillation Am J Physiol Heart Circ Physiol, April 1, 2008; 294(4): H1896 - H1905. [Abstract] [Full Text] [PDF] |
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