Abstract
Background
Cardiac Arrest (CA) is one of the leading causes of mortality worldwide. The present study aimed to establish a simple and stable rat model of CA induced by transesophageal cardiac pacing for the investigation of cerebral resuscitation.
Materials and Methods
A total of 26 healthy adult male Sprague-Dawley rats were randomly allocated into two groups: Sham-operated (n = 6) and experimental (n = 20) groups. High-frequency cardiac pacing (50 Hz, 2 ms and 30 V) was maintained for 3 min to induce CA. Providing CA was not achieved, an additional 2 min of pacing was performed 30 min later. After 4 min following the onset of CA, Cardiopulmonary Resuscitation (CPR) was initiated.
Results
CA was successfully induced in all 20 rats by this setting of high-frequency cardiac pacing. Among them, CA was induced in six rats after 2 min of pacing; the remaining 14 rats underwent CA after 3 min of pacing. When electrical stimulation was terminated the rate of Pulseless Electrical Activity (PEA) was 85% (17/20), the rate of Ventricular Fibrillation (VF) was 15% (3/20) and no asystole occurred. Of the 17 PEA rats, 16 were successfully resuscitated and the average duration of CPR was 106.75 ± 30.81 s. A total of three rats succumbed within 24 h, and one rat succumbed between 24 and 48 h following successful resuscitation; 12 rats survived to <72 h. In addition, three rats with VF were successfully resuscitated and the average duration of CPR was 264.33 ± 130.40 s; one rat succumbed between 24 and 48 h following successful resuscitation, and two rats survived to <72 h. The 72 h-survival rate was 74%. No notable injury the esophagus was observed in the rats. Compared with the Sham group, the neurological function of the CA group was significantly impaired (p < 0.05); cells in the hippocampal CA1 region of the CA group were significantly damaged (p < 0.05).
Conclusion
The model of CA induced by transesophageal cardiac pacing in the present study is easy and replicable. Therefore, this model may be used for experimental research into cerebral resuscitation.
Article PDF
Avoid common mistakes on your manuscript.
References
Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics—2017 update: a report from the American heart association. Circulation 2017; 135;e146–e603.
Zhang S. Sudden cardiac death in China: current status and future perspectives. EP Europace 2015;17;ii14–ii18.
The Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346;549–56.
Arrich J, Holzer M, Havel C, Müllner M, Herkner H. Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation. Cochrane Database Syst Rev 2016;2;CD004128.
Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346;557–63.
Nielsen N, Hovdenes J, Nilsson F, Rubertsson S, Stammet P, Sunde K, et al. Outcome, timing and adverse events in therapeutic hypothermia after out-of-hospital cardiac arrest. Acta Anaesthesiol Scand 2009;53;926–34.
Nielsen N, Friberg H, Gluud C, Herlitz J, Wetterslev J. Hypothermia after cardiac arrest should be further evaluated—a systematic review of randomised trials with meta-analysis and trial sequential analysis. Int J Cardiol 2011;151;333–41.
Fisher GC. Hypothermia after cardiac arrest: feasible but is it therapeutic?. Anaesthesia 2008;63;885–6; author reply 886.
Nielsen N, Wetterslev J, Cronberg T, Erlinge D, Gasche Y, Hassager C, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med 2013;369;2197–206.
Vognsen M, Fabian-Jessing BK, Secher N, Løfgren B, Dezfulian C, Andersen LW, et al. Contemporary animal models of cardiac arrest: a systematic review. Resuscitation 2017;113;115–23.
Tang PT, Shenasa M, Boyle NG. Ventricular arrhythmias and sudden cardiac death. Card Electrophysiol Clin 2017;9;693–708.
Engdahl J, Holmberg M, Karlson BW, Luepker R, Herlitz J. The epidemiology of out-of-hospital ‘sudden’ cardiac arrest. Resuscitation 2002;52;235–45.
von Planta I, Weil MH, von Planta M, Bisera J, Bruno S, Gazmuri RJ, et al. Cardiopulmonary resuscitation in the rat. J Appl Physiol (1985) 1988;65;2641–7.
Böttiger BW, Krumnikl JJ, Gass P, Schmitz B, Motsch J, Martin E. The cerebral ‘no-reflow’ phenomenon after cardiac arrest in rats— influence of low-flow reperfusion. Resuscitation 1997;34;79–87.
Kofler J, Hattori K, Sawada M, DeVries AC, Martin LJ, Hurn PD, et al. Histopathological and behavioral characterization of a novel model of cardiac arrest and cardiopulmonary resuscitation in mice. J Neurosci Methods 2004;136;33–44.
Lin Jy, Liao Xx, Li H, Wei Hy, Liu R, Hu Cl, et al. Model of cardiac arrest in rats by transcutaneous electrical epicardium stimulation. Resuscitation 2010;81;1197–204.
Chen MH, Liu TW, Xie L, Song FQ, He T, Zeng Zy, et al. A simpler cardiac arrest model in rats. Am J Emerg Med 2007;25; 623–30.
Chen MH, Liu TW, Xie L, Song FQ, He T, Zeng ZY, et al. Ventricular fibrillation induced by transoesophageal cardiac pacing: a new model of cardiac arrest in rats. Resuscitation 2007;74;546–51.
Idris AH, Becker LB, Ornato JP, Hedges JR, Bircher NG, Chandra NC, et al. Utstein-style guidelines for uniform reporting of laboratory CPR research. A statement for healthcare professionals from a task force of the American Heart Association, the American College of Emergency Physicians, the American College of Cardiology, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Institute of Critical Care Medicine, the Safar Center for Resuscitation Research, and the Society for Academic Emergency Medicine. Writing Group. Circulation 1996;94;2324–36.
Katz L, Ebmeyer U, Safar P, Radovsky A, Neumar R. Outcome model of asphyxial cardiac arrest in rats. J Cereb Blood Flow Metab 1995;15;1032–9.
Atwood C, Eisenberg MS, Herlitz J, Rea TD. Incidence of EMS-treated out-of-hospital cardiac arrest in Europe. Resuscitation 2005;67;75–80.
Papadimitriou D, Xanthos T, Dontas I, Lelovas P, Perrea D. The use of mice and rats as animal models for cardiopulmonary resuscitation research. Lab Anim 2008;42;265–76.
Damiano RJ, Asano T, Smith PK, Cox JL. Effect of the right ventricular isolation procedure on ventricular vulnerability to fibrillation. J Am Coll Cardiol 1990;15;730–6.
Manoach M. Factors influencing maintenance and spontaneous termination of ventricular fibrillation. Int J Cardiol 1984;5; 398–402.
Varvarousis D, Varvarousi G, Iacovidou N, D’Aloja E, Gulati A, Xanthos T. The pathophysiologies of asphyxial vs dysrhythmic cardiac arrest: implications for resuscitation and post-event management. Am J Emerg Med 2015;33;1297–304.
Uray T, Lamade A, Elmer J, Drabek T, Stezoski JP, Missé A, et al. Phenotyping cardiac arrest: bench and bedside characterization of brain and heart injury based on etiology. Crit Care Med 2018;46;e508–e15.
Fumagalli F, Russo I, Staszewsky L, Li Y, Letizia T, Masson S, et al. Ranolazine ameliorates postresuscitation electrical instability and myocardial dysfunction and improves survival with good neurologic recovery in a rat model of cardiac arrest. Heart Rhythm 2014;11;1641–7.
Granfeldt A, Wissenberg M, Hansen SM, Lippert FK, Lang-Jensen T, Hendriksen OM, et al. Clinical predictors of shockable versus non-shockable rhythms in patients with out-of-hospital cardiac arrest. Resuscitation 2016;108;40–7.
Author information
Authors and Affiliations
Corresponding author
Additional information
Peer review under responsibility of the First Affiliated Hospital of Zhengzhou University
Data availability statement: The data that support the findings of this study are available from the corresponding author [ZY], upon reasonable request.
Rights and permissions
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
About this article
Cite this article
Lian, Y., Yao, L., Xu, S. et al. Transesophageal Pacing Cardiac Induces Cardiac Arrest and Subsequent Brain Injury in Rats. Intensive Care Res 1, 37–44 (2021). https://doi.org/10.2991/icres.k.211111.001
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.2991/icres.k.211111.001