Skip to main content

How to Induce Arrhythmias with Noradrenaline

  • Chapter
  • First Online:
  • 949 Accesses

Abstract

Noradrenaline is a precursor of adrenaline, secreted by the adrenal part of the medulla, and like dopamine is a neurotransmitter found in the brain and other parts of the body. Noradrenaline is important in the response and recovery after injury or serious illness. Furthermore, significant plasma levels are seen in patients with different types of shock, severe hypoxemia, or cardiac failure. Cellular response to noradrenaline is mediated by receptors that are located on target cells. It has the potential of facilitating cardiac arrhythmias by β1 receptor stimulation, alpha-1 receptor stimulation, or increase in myocardial oxygen consumption. When noradrenaline is injected intravenously, a rise in the blood pressure occurs rapidly. The effect is of short duration. After 1–2 min of discontinuation of infusion, the pressor response disappears. Noradrenaline is a sympathicomimetic with a double effect on the α and β postsynaptic receptors. Furthermore, sympathetic stimulation by noradrenaline leads to adrenaline secretion from the medulosuprarenal gland, with further effect on the α and β receptors. On the other hand, the effects of noradrenaline are different of those of adrenaline, even though they both act on the α and β receptors.

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

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   109.99
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

Learn about institutional subscriptions

References

  1. von Euler US, Harnberg U. L-noradrenaline in the suprarenal medulla. Nature. 1949;163:642–63.

    Article  Google Scholar 

  2. Weiss R, Knight BP, Bahu M, Zivin A, Souza J, Goyal R, Daoud E, Man C, Strickberger A, Halter JB, Morady F. Cardiac electrophysiologic effects of norepinephrine in human beings. Am Heart J. 1998;135:945–51.

    Article  CAS  Google Scholar 

  3. Brown RA, Carpentier RG. Alpha-adrenoreceptor- mediated effects of norepinephrine on the guinea pig sinus node. J Electrocardiol. 1988;21:213–7.

    Article  CAS  Google Scholar 

  4. Gilbert JL, Lange G, Polevoy I, Brooks CM. Effects of vasoconstrictor agents on cardiac irritability. J Pharmacol Exp Ther. 1958;123:9–15.

    CAS  PubMed  Google Scholar 

  5. Hauswirth O, Noble D, Tsien RW. Adrenaline: mechanism of action on the pacemaker potential in cardiac Purkinje fibers. Science. 1968;162:916–7.

    Article  CAS  Google Scholar 

  6. Brown RA, Carpentier RG. Alpha-adrenoceptor-mediated effects of norepinephrine on the guinea pig sinus node. J Electrocardiol. 1988;21:213–7.

    Article  CAS  Google Scholar 

  7. Fedida D, Shimoni Y, Giles WR. A novel effect of norepinephrine on cardiac cells is mediated by alpha adrenoceptors. Am J Physiol. 1989;256:H15lXl-4.

    Google Scholar 

  8. Lukas A, Ferrier GR. Arrhythmic effects of norepinephrine in a model of cardiac ischemia and reperfusion. Can J Physiol Pharmacol. 1989;67:765–71.

    Article  CAS  Google Scholar 

  9. Friedrichs GS, Merrill GF. Adenosine desaminase and adenosine attenuate ventricular arrhythmias caused by norepinephrine. Am J Phys. 1991;260:H979–84.

    CAS  Google Scholar 

  10. Wax SD, Webb WR, Ecker RR, Sugg WL. Evaluation of antifibrillatory agents and catecholamines by a physiologic method. Surg Forum. 1968;19:J49–51.

    Google Scholar 

  11. Papp JG, Szekeres L. Analysis of the mechanism of adrenergic actions on ventricular vulnerability. Eur J Pharmacol. 1968;3:15–26.

    Article  CAS  Google Scholar 

  12. Sharma AD, Waxman MB, Huerta F. Effect of adrenergic stimulation and blockade on ventricular defibrillation in the rat. J Pharmacol Exp Ther. 1983;227:716–22.

    CAS  PubMed  Google Scholar 

  13. Goldenberg M, Pines KL, Baldwin EF, Green DG, Roh CE. The hemodynamic response of man to norepinephrine and epinephrine and relation to the problem of hypertension. Am J Med. 1948;5:792–806.

    Article  CAS  Google Scholar 

  14. Desjars P, Pinaud M, Potel G, Tasseau F, Touze MD. A reappraisal of norepinephrine therapy in human septic shock. Crit Care Med. 1987;15:134–7.

    Article  CAS  Google Scholar 

  15. De Baker D, Biston P, Devriendt J, et al. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med. 2010;362:779–89.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Alexandru, I. (2019). How to Induce Arrhythmias with Noradrenaline. In: Cismaru, G. (eds) Arrhythmia Induction in the EP Lab. Springer, Cham. https://doi.org/10.1007/978-3-319-92729-9_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-92729-9_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92728-2

  • Online ISBN: 978-3-319-92729-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics