Skip to main content

Mechanisms of Ventricular Arrhythmias in Ischaemic Heart Disease

  • Chapter
Cardiac Arrhythmias, Pacing & Electrophysiology

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 201))

Abstract

Ventricular tachycardia and ventricular fibrillation are serious complications of myocardial infarction and ischaemic heart disease. Different electrophysiological mechanisms may give rise to ventricular arrhythmias in myocardial ischaemia and infarction. A better understanding of these mechanisms will provide a basis for improved management. More precise information is difficult to obtain from clinical electrophysiological studies because of the limitations of the experimental protocols and techniques that can be utilised. This information could be obtained, however, from successful extrapolations from experimental studies on appropriate animal models to humans. In this chapter the electrophysiological mechanisms of ventricular arrhythmias in myocardial ischaemia and infarction are reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. El-Sherif N, Gough WB, Restivo M. Boutjdir M. Electrophysiology of ventricular arrhythmias in myocardial ischemia and infarction. In: El-Sherif N, Samet P, editors. Cardiac Pacing and Electrophysiology. Philadelphia: Saunders; 1991: 18–56.

    Google Scholar 

  2. El-Sherif N, Scherlag BJ, Lazzara R. Hope RR. Reentrant ventricular arrhythmias in the late myocardial infarction period. 1. Conduction characteristics in the infarction zone. Circulation 1977; 55: 686–702.

    Article  PubMed  CAS  Google Scholar 

  3. El-Sherif N, Smith RA, Evans K. Canine ventricular arrhythmias in the late myocardial infarction period. 8. Epicardial mapping of reentrant circuits. Circ Res 1981; 49: 255–65.

    Article  PubMed  CAS  Google Scholar 

  4. Downar E, Janse MJ, Durrer D. The effect of acute coronary artery occlusion on subepicardial transmembrane potentials in the intact porcine heart. Circulation 1977; 56: 217–24.

    Article  PubMed  CAS  Google Scholar 

  5. El-Sherif N, Scherlag BJ, Lazzara R, Samet P. The pathophysiology of tachycardia-and bradycardia-dependent block in the canine proximal His-Purkinje system following acute myocardial ischemia. Am J Cardiol 1974; 34: 529–40.

    Article  Google Scholar 

  6. Janse MJ, Kleber AG. Electrophysiologic changes and ventricular arrhythmias in the early phase of myocardial ischemia. Circ Res 1981; 49: 1069–81.

    Article  PubMed  CAS  Google Scholar 

  7. Janse MJ, Van Cappelle FJL, Morsink H et al. Flow of “injury” current and patterns of excitation during early ventricular arrhythmias in acute regional myocardial ischemia in isolated porcine and canine hearts. Evidence for two different arrhythmogenic mechanisms. Circ Res 1980; 47: 151–65.

    Article  PubMed  CAS  Google Scholar 

  8. Pogwizd SM, Corr PB. Reentrant and nonreentrant mechanisms contribute to arrhythmogenesis during early myocardial ischemia. Results using three-dimensional mapping. Circ Res 1987; 61: 352–71.

    Article  PubMed  CAS  Google Scholar 

  9. Friedman PL, Stewart JR, Wit AL. Spontaneous and induced cardiac arrhythmias in subendocardial Purkinje fibers surviving extensive myocardial infarction in dogs. Circ Res 1973; 33: 612–26.

    Article  PubMed  CAS  Google Scholar 

  10. El-Sherif N, Gough WB, Zeiler RH, Mehra R. Triggered ventricular rhythms in one-day-old myocardial infarction in the dog. Circ Res 1983; 52: 566–79.

    Article  PubMed  CAS  Google Scholar 

  11. January CP, Fozzard HA. Delayed afterdepolarizations in heart muscles: mechanisms and relevance. Pharmacol Rev 1988; 40: 219–27.

    PubMed  CAS  Google Scholar 

  12. El-Sherif N. The figure-8 model of reentrant excitation in the canine postinfarction heart. In: Zipes DP, Jalife J, editors. Cardiac Electrophysiology and Arrhythmias, Orlando, FL: Grune & Stratton; 1985: 365–78.

    Google Scholar 

  13. El-Sherif N, Mehra R, Gough WB, Zeiler RH. Reentrant ventricular arrhythmias in the late myocardial infarction period. Interruption of reentrant circuits by cryothermal techniques. Circulation 1983; 8: 644–56.

    Article  Google Scholar 

  14. El-Sherif N, Lazzara R. Reentrant ventricular arrhythmias in the late myocardial infarction period. 7. Effects of verapamil and D-600 and role of the “slow channel”. Circulation 1979; 60: 605–15.

    Article  PubMed  CAS  Google Scholar 

  15. Spear JF, Michelson EL, Moore EN. Reduced space constant in slowly conducting regions of chronically infarcted canine myocardium. Circ Res 1983; 53: 176–85.

    Article  PubMed  CAS  Google Scholar 

  16. Peters NS, Coromilas J, Severs NJ, Wilt AL. Disturbed connexin-43 gap junction distribution correlates with the location of reentrant circuits in the epicardial border zone of healing canine infarcts that cause ventricular tachycardia. Circulation 1997; 95: 988–96.

    Article  PubMed  CAS  Google Scholar 

  17. Dillon S. Allessie MA, Ursell PC, Wit AL. Influences of anisotropic tissue structure on reentrant circuits in the epicardial border zone of subacute canine infarcts. Cire Res 1988; 63: 182–206.

    Article  CAS  Google Scholar 

  18. Restivo M, Gough WB, El-Sherif N. Ventricular arrhythmias in the subacute myocardial infarction period: high resolution activation and refractory patterns of reentrant rhythms. Circ Res 1990; 66: 1310–27.

    Article  PubMed  CAS  Google Scholar 

  19. Belichard P. Savard P. Cardinal R et al. Markedly different effects on ventricular remodeling result in a decrease in inducibility of ventricular arrhythmias. J Am Coll Cardiol 1994; 23: 505–13.

    Article  PubMed  CAS  Google Scholar 

  20. Aronson RS, Ming Z. Cellular mechanisms of arrhythmias in hypertrophied and failing myocardium. Circulation 1993:87(suppl. VII):VII-76–83.

    Google Scholar 

  21. Qin D, Jain P. Boutjdir M, El-Sherif N. Expression of T-type calcium current in remodeled hypertrophied left ventricle from adult rat following myocardial infarction. Circulation 1995; 92: 7–587 (abstract).

    Google Scholar 

  22. Gidh-Jain M, Huang B, Jain P, Battula V, El-Sherif N. Reemergence of the fetal pattern of L-type calcium channel gene expression in noninfarcted myocardium during left ventricular remodeling. Biochem Biophys Res Commun 1995; 216: 892–7.

    Article  PubMed  CAS  Google Scholar 

  23. Qin D, Zhang Z-H, Caref EB, Boutjdir M, Jain P, El-Sherif N. Cellular and ionic basis of arrhythmias in postinfarction remodeled ventricular myocardium. Circ Res 1996; 79: 461–73.

    Article  PubMed  CAS  Google Scholar 

  24. Gidh-Jain M, Huang B, Jain P, El-Sherif N. Differential expression of voltage-gated K+ channel genes in left ventricular remolded myocardium after experimental myocardial infarction. Circ Res 1996; 79: 669–75.

    Article  PubMed  CAS  Google Scholar 

  25. Barry DM, Trimmer JS, Merlie JP, Nerbonne JM. Differential expression of voltage-gated K channel subunits in adult rat heart relation to function K channels. Circ Res 1995; 77: 361–9.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

El-Sherif, N. (1998). Mechanisms of Ventricular Arrhythmias in Ischaemic Heart Disease. In: Vardas, P.E. (eds) Cardiac Arrhythmias, Pacing & Electrophysiology. Developments in Cardiovascular Medicine, vol 201. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5254-9_8

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-5254-9_8

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6210-7

  • Online ISBN: 978-94-011-5254-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics