Inducibility of ventricular fibrillation during mild therapeutic hypothermia: electrophysiological study in a swine model

Kudlicka, Jaroslav; Mlček, Mikuláš; Bělohlávek, Jan; Hála, Pavel; Lacko, Stanislav; Janák, David; Havránek, Štěpán; Malík, Jan; Janota, Tomáš; Ošťádal, Petr; Neužil, Petr; Kittnar, O

doi:10.1186/s12967-015-0429-9

Cited by 11 publications

(7 citation statements)

References 47 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Combined analysis of the RAPID MI-ICE and the CHILL-MI trials also exhibited no difference in atrial fibrillation incidence ( 24 ). Within the temperature range used in STEMI cooling studies, no significant increase in ventricular arrhythmias has been reported ( 22 , 24 ), a finding consistent with animal studies ( 25 ). Taken together, mild TH seems not to significantly increase the occurrence of arrhythmia in general STEMI patients, but there could be a subpopulation of patients more prone to the development of arrhythmias, such as those with electrolyte dysregulation.…”

Section: Ecg Changes and Arrhythmias Associated With Thsupporting

confidence: 79%

Effects of Therapeutic Hypothermia on Normal and Ischemic Heart

Yamada

Kariya

Aikawa

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Therapeutic hypothermia has been used for treating brain injury after out-of-hospital cardiac arrest. Its potential benefit on minimizing myocardial ischemic injury has been explored, but clinical evidence has yet to confirm positive results in preclinical studies. Importantly, therapeutic hypothermia for myocardial infarction is unique in that it can be initiated prior to reperfusion, in contrast to its application for brain injury in resuscitated cardiac arrest patients. Recent advance in cooling technology allows more rapid cooling of the heart than ever and new clinical trials are designed to examine the efficacy of rapid therapeutic hypothermia for myocardial infarction. In this review, we summarize current knowledge regarding the effect of hypothermia on normal and ischemic hearts and discuss issues to be solved in order to realize its clinical application for treating acute myocardial infarction.

show abstract

Section: Ecg Changes and Arrhythmias Associated With Thsupporting

confidence: 79%

Effects of Therapeutic Hypothermia on Normal and Ischemic Heart

Yamada

Kariya

Aikawa

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…After the completion of invasive procedures and a minimum of 15 min of stabilization, baseline values were obtained. Thereafter, CA was commenced by induction of ventricular fibrillation (VF) using programmed right ventricular stimulation as described previously [ 16 ]; mechanical ventilation was stopped during CA period. As shown in the protocol outline (Fig.…”

Section: Methodsmentioning

confidence: 99%

Microcirculatory blood flow during cardiac arrest and cardiopulmonary resuscitation does not correlate with global hemodynamics: an experimental study

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundCurrent research highlights the role of microcirculatory disorders in post-cardiac arrest patients. Affected microcirculation shows not only dissociation from systemic hemodynamics but also strong connection to outcome of these patients. However, only few studies evaluated microcirculation directly during cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). The aim of our experimental study in a porcine model was to describe sublingual microcirculatory changes during CA and CPR using recent videomicroscopic technology and provide a comparison to parameters of global hemodynamics.MethodsCardiac arrest was induced in 18 female pigs (50 ± 3 kg). After 3 min without treatment, 5 min of mechanical CPR followed. Continuous hemodynamic monitoring including systemic blood pressure and carotid blood flow was performed and blood lactate was measured at the end of baseline and CPR. Sublingual microcirculation was assessed by the Sidestream Dark Field (SDF) technology during baseline, CA and CPR. Following microcirculatory parameters were assessed off-line separately for capillaries (≤20 µm) and other vessels: total and perfused vessel density (TVD, PVD), proportion of perfused vessels (PPV), microvascular flow index (MFI) and heterogeneity index (HI).ResultsIn comparison to baseline the CA small vessel microcirculation was only partially preserved: TVD 15.64 (13.59–18.48) significantly decreased to 12.51 (10.57–13.98) mm/mm2, PVD 15.57 (13.56–17.80) to 5.53 (4.17–6.60) mm/mm2, PPV 99.64 (98.05–100.00) to 38.97 (27.60–46.29) %, MFI 3.00 (3.00–3.08) to 1.29 (1.08–1.58) and HI increased from 0.08 (0.00–0.23) to 1.5 (0.71–2.00), p = 0.0003 for TVD and <0.0001 for others, respectively. Microcirculation during ongoing CPR in small vessels reached 59–85 % of the baseline values: TVD 13.33 (12.11–15.11) mm/mm2, PVD 9.34 (7.34–11.52) mm/mm2, PPV 72.34 (54.31–87.87) %, MFI 2.04 (1.58–2.42), HI 0.65 (0.41–1.07). The correlation between microcirculation and global hemodynamic parameters as well as to lactate was only weak to moderate (i.e. Spearman’s ρ 0.02–0.51) and after adjustment for multiple correlations it was non-significant.ConclusionsSublingual microcirculatory parameters did not correlate with global hemodynamic parameters during simulated porcine model of CA and CPR. SDF imaging provides additional information about tissue perfusion in the course of CPR.Electronic supplementary materialThe online version of this article (doi:10.1186/s12967-016-0934-5) contains supplementary material, which is available to authorized users.

show abstract

“…Although cardiac conduction is modified during therapeutic hypothermia, clinical studies show no significant increase in the risk of dysrhythmias when cooling to 32-35°C. [54][55][56][57] The first effect that therapeutic hypothermia has on cardiac function is a decrease in HR. 58 Recently, bradycardia during therapeutic hypothermia has even been associated with better outcomes.…”

Section: The Cardiac Pacemaker and Cardiac Conductionmentioning

confidence: 99%

Editor’s Choice- Inside the cold heart: A review of therapeutic hypothermia cardioprotection

Chavez

León

Einav

et al. 2016

European Heart Journal: Acute Cardiovascular Care

View full text Add to dashboard Cite

Targeted temperature management has been originally used to reduce neurological injury and improve outcome in patients after out-of-hospital cardiac arrest. Myocardial infarction remains a major cause of death in the world and several investigators are studying the effect of mild therapeutic hypothermia during an acute cardiac ischemic injury. A search on MEDLINE, Scopus and EMBASE databases was conducted to obtain data regarding the cardioprotective properties of therapeutic hypothermia. Preclinical studies have shown that therapeutic hypothermia provides a cardioprotective effect in animals. The proposed pathways for the cardioprotective effects of therapeutic hypothermia include stabilization of mitochondrial permeability, production of nitric oxide, equilibration of reactive oxygen species, and calcium channels homeostasis. Clinical trials in humans have yielded controversial results. Current trials are therefore seeking to combine therapeutic hypothermia with other treatment modalities in order to improve the outcomes of patients with acute ischemic injury. This article provides a review of the hypothermia effects on the cardiovascular system, from the basic science of physiological changes in the human body and molecular mechanisms of cardioprotection to the bench of clinical trials with therapeutic hypothermia in patients with acute ischemic injury.

show abstract

Inducibility of ventricular fibrillation during mild therapeutic hypothermia: electrophysiological study in a swine model

Cited by 11 publications

References 47 publications

Effects of Therapeutic Hypothermia on Normal and Ischemic Heart

Effects of Therapeutic Hypothermia on Normal and Ischemic Heart

Microcirculatory blood flow during cardiac arrest and cardiopulmonary resuscitation does not correlate with global hemodynamics: an experimental study

Editor’s Choice- Inside the cold heart: A review of therapeutic hypothermia cardioprotection

Contact Info

Product

Resources

About