標題: Ventricular divergence correlates with epicardial wavebreaks and predicts ventricular arrhythmia in isolated rabbit hearts during therapeutic hypothermia
作者: Hsieh, Yu-Cheng
Hsieh, Wan-Hsin
Li, Cheng-Hung
Liao, Ying-Chieh
Lin, Jiunn-Cherng
Weng, Chi-Jen
Lo, Men-Tzung
Tuan, Ta-Chuan
Lin, Shien-Fong
Yeh, Hung-, I
Huang, Jin-Long
Haugan, Ketil
Larsen, Bjarne D.
Lin, Yenn-Jiang
Lin, Wei-Wen
Wu, Tsu-Juey
Chen, Shih-Ann
分子醫學與生物工程研究所
Institute of Molecular Medicine and Bioengineering
公開日期: 21-二月-2020
摘要: Introduction High beat-to-beat morphological variation (divergence) on the ventricular electrogram during programmed ventricular stimulation (PVS) is associated with increased risk of ventricular fibrillation (VF), with unclear mechanisms. We hypothesized that ventricular divergence is associated with epicardial wavebreaks during PVS, and that it predicts VF occurrence. Method and results Langendorff-perfused rabbit hearts (n = 10) underwent 30-min therapeutic hypothermia (TH, 30 degrees C), followed by a 20-min treatment with rotigaptide (300 nM), a gap junction modifier. VF inducibility was tested using burst ventricular pacing at the shortest pacing cycle length achieving 1:1 ventricular capture. Pseudo-ECG (p-ECG) and epicardial activation maps were simultaneously recorded for divergence and wavebreaks analysis, respectively. A total of 112 optical and p-ECG recordings (62 at TH, 50 at TH treated with rotigaptide) were analyzed. Adding rotigaptide reduced ventricular divergence, from 0.13 +/- 0.10 at TH to 0.09 +/- 0.07 (p = 0.018). Similarly, rotigaptide reduced the number of epicardial wavebreaks, from 0.59 +/- 0.73 at TH to 0.30 +/- 0.49 (p = 0.036). VF inducibility decreased, from 48 +/- 31% at TH to 22 +/- 32% after rotigaptide infusion (p = 0.032). Linear regression models showed that ventricular divergence correlated with epicardial wavebreaks during TH (p<0.001). Conclusion Ventricular divergence correlated with, and might be predictive of epicardial wavebreaks during PVS at TH. Rotigaptide decreased both the ventricular divergence and epicardial wavebreaks, and reduced the probability of pacing-induced VF during TH.
URI: http://dx.doi.org/10.1371/journal.pone.0228818
http://hdl.handle.net/11536/154563
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0228818
期刊: PLOS ONE
Volume: 15
Issue: 2
起始頁: 0
結束頁: 0
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