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Changes in ventricular fibrillation threshold during repeated short-term coronary occlusion and release

Veränderungen der ventrikulären Flimmerschwelle des Herzens während repetierter Koronarverschlüsse und Reperfusionen

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Summary

The time course of changes in VFT was determined during the 1st phase of arrhythmia following coronary occlusion and during consecutive reperfusion in five repeated periods of occlusion and reperfusion in 10 mongrel dogs (17–24 kg). VFT was determined using a square wave pulse series of 140 ms duration which was triggered by the R-wave of the ECG and placed into the vulnerable period of the cardiac cycle. After acute occlusion VFT decreased to a minimum level within a few minutes and then increased again slowly up to the control value which was reached about 20 min after the ligation. When the occlusions were repeated several times the extent of the decrease in VFT became increasingly less and its duration increasingly shorter until finally there was no significant decrease in VFT. Reperfusion after coronary occlusion led to an abrupt decrease in VFT within 1 min, followed by a rapid increase to the control value. This time course did not depend upon the number of prior occlusions. The results show that in the case of repeating short-term coronary occlusions one cannot expect comparable VFT time courses for the consecutive periods of occlusion except for the 1st and 2nd ones. Differing mechanisms leading to the occurrence of VF after coronary ligation and during reperfusion are discussed.

Zusammenfassung

An 10 mischrassigen Hunden (KG 17–24 kg) wurden die Veränderungen der Flimmerschwelle des Herzens in der ersten Phase nach akutem Koronarverschluß, während nachfolgender Reperfusion und bei 1- bis 4facher Repetierung der Okklusion und Reperfusion in Ausmaß und zeitlichem Ablauf ermittelt. Die Bestimmung der Flimmerschwelle erfolgte mit Rechteckstromserienreizen (Dauer: 140 msec), die R-Zacken-getriggert direkt in die vulnerable Phase des Herzens plaziert wurden. Nach akutem Koronarverschluß fiel die Flimmerschwelle rasch ab und stieg dann wieder langsam an, bis ca. 20 Minuten nach dem Verschluß die Kontrollwerte wieder erreicht wurden. Bei Repetierung der Okklusionen wurde das Ausmaß des Flimmerschwellenabfalls mit steigender Zahl der Verschlüsse zunehmend kleiner, die Dauer der Senkung kürzer. Schließlich war kein statistisch signifikanter Abfall der Flimmerschwelle mehr nachweisbar. Die Freigabe der Wiederdurchblutung nach Koronarverschluß führte zu einem abrupten Abfall der Flimmerschwelle innerhalb einer Minute und nachfolgend zu einem ebenso raschen Wiederanstieg auf die Kontrollwerte. Dieser Verlauf war unabhängig von der Anzahl vorheriger Okklusionen. Die Ergebnisse belegen, daß bei wiederholten kurzzeitigen Koronarverschlüssen nicht mit vergleichbaren Flimmerschwellenzeitverläufen gerechnet werden kann mit Ausnahme der 1. und 2. Verschlußperiode. Unterschiedliche Mechanismen werden diskutiert, die zu Kammerflimmern nach akutem Koronarverschluß und während der Reperfusion führen können.

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  1. H. Gülker, B. Krämer, K. Stephan & W. Meesmann

    Present address: Institut für Pathologische Physiologie am Klinikum der Universität Essen (Gesamthochschule), Hufelandstraße 55, 4300, Essen, West Germany

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    This project was supported by a grant from the Landesamt für Wissenschaft und Forschung, Düsseldorf, W. Germanny

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    Gülker, H., Krämer, B., Stephan, K. et al. Changes in ventricular fibrillation threshold during repeated short-term coronary occlusion and release. Basic Res Cardiol 72, 547–562 (1977). https://doi.org/10.1007/BF01910416

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