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Nonhomogeneous electrophysiological changes and the bimodal distribution of early ventricular arrhythmias during acute coronary artery occlusion

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Summary

There is experimental evidence that the bimodally distributed ventricular arrhythmias (phases Ia and Ib) during the first 30 min after coronary occlusion (CO) in dogs are not due to the same mechanism. In 39 dogs we related the incidence of phases Ia and Ib to the time courses of excitation thresholds (ET), refractoriness (REFR), conduction times (CT) and effective refractory periods (ERP) at 6–12 epicardial electrode sites within the ischemic zone. The regional collateral myocardial blood flow (RMBF-tracer microsphere technique) was determined in 14 out of the dogs. This measurement only served for rough grouping into dogs with low and higher RMBF at the electrode sites during ischemia. REFR was determined as temporal recovery of excitability at a constant current strength of 4–6 times preocclusion ET. ERP was intermittently measured at 2.0–8.0 mA. At low RMBF ET, REFR and CT increased very

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Abbreviations

CT:

conduction time

DispERP :

dispersion of effective refractory periods

EL:

electrode

ERP:

effective refractory period

ET:

excitation threshold

LAD:

left anterior descending coronary artery

R1 :

S1-paced basic ventricular excitation

R2 :

S2-induced ventricular extrasystole

REFR:

refractoriness

RMBF:

regional myocardial blood flow

RMBFIZ :

regional myocardial blood flow at the ischemic electrode site

RMBFNZ :

regional myocardial blood flow within normally perfused left ventricular myocardium

S1 :

pacing stimulus

S2 :

premature stimulus for determination of refractoriness

SIC:

strength-interval curve

SS:

stimulus strength

TM:

tracer microspheres

VA:

ventricular arrhythmia

VES:

ventricular extrasystole

VF:

ventricular fibrillation

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Author notes

  1. W. Meesmann

    Present address: Department of Pathophysiology, Centrum of Internal Medicine, Univ.-Klinikum Essen, Hufelandstr. 55, 4300, Essen, FRG

Authors and Affiliations

  1. Institute of Pathophysiology, University of Essen, FRG

    Th. Horacek, M. Neumann, Sabine von Mutius, Monika Budden &  W. Meesmann

Authors
  1. Th. Horacek
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  2. M. Neumann
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  3. Sabine von Mutius
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  4. Monika Budden
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Supported by the Minister für Wissenschaft und Forschung des Landes NRW, FRG.

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Horacek, T., Neumann, M., von Mutius, S. et al. Nonhomogeneous electrophysiological changes and the bimodal distribution of early ventricular arrhythmias during acute coronary artery occlusion. Basic Res Cardiol 79, 649–667 (1984). https://doi.org/10.1007/BF01908383

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  • DOI: https://doi.org/10.1007/BF01908383

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