Moderate but not severe hypothermia causes pro-arrhythmic changes in cardiac electrophysiology
| Autor: | Erik Sveberg Dietrichs, Karen McGlynn, Rachel C. Myles, Andrew Allan, Sarah Kettlewell, Godfrey L. Smith, Martin J. Bishop, Adam Connolly, Torkjel Tveita, Francis L. Burton |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Physiology 030204 cardiovascular system & hematology QT interval 03 medical and health sciences QRS complex 0302 clinical medicine Physiology (medical) Internal medicine medicine Repolarization VDP::Medisinske Fag: 700 cardiovascular diseases Heptanol Cardiac electrophysiology business.industry 030208 emergency & critical care medicine Hypothermia medicine.disease Electrophysiology Ventricular fibrillation Cardiology cardiovascular system medicine.symptom Cardiology and Cardiovascular Medicine business |
| ISSN: | 0008-6363 |
| Popis: | Aims Treatment of arrhythmias evoked by hypothermia/rewarming remains challenging, and the underlying mechanisms are unclear. This in vitro experimental study assessed cardiac electrophysiology in isolated rabbit hearts at temperatures occurring in therapeutic and accidental hypothermia. Methods and results Detailed ECG, surface electrogram, and panoramic optical mapping were performed in isolated rabbit hearts cooled to moderate (31°C) and severe (17°C) hypothermia. Ventricular activation was unchanged at 31°C while action potential duration (APD) was significantly prolonged (176.9 ± 4.2 ms vs. 241.0 ± 2.9 ms, P Conclusions Moderate hypothermia does not significantly change ventricular conduction time but prolongs repolarization and is pro-arrhythmic. Further cooling to severe hypothermia causes parallel changes in ventricular activation and repolarization, changes which are anti-arrhythmic. Therefore, relative changes in QRS and QT intervals (QR/QTc) emerge as an ECG-biomarker of pro-arrhythmic activity. Risk for ventricular fibrillation appears to be linked to the relatively low temperature sensitivity of ventricular transmural conduction, a conclusion supported by the anti-arrhythmic effect of heptanol at 31°C. |
| Databáze: | OpenAIRE |
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