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The Ischemic Heart pp 279–303Cite as

Early and Delayed Protection Against Ventricular Arrhythmias Induced by Preconditioning

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Part of the book series: Progress in Experimental Cardiology ((PREC,volume 1))

Abstract

Ischemic preconditioning, induced by brief periods of coronary artery occlusion, results not only in a reduction in myocardial ischemic damage but also in suppression of those life-threatening ventricular arrhythmias that result from a subsequent, more prolonged ischemia-reperfusion insult. Although this protection is marked, the antiarrhythmic effect is transient and the protection wanes with time (e.g., 60 minutes after the preconditioning stimulus, the antiarrhythmic effect is almost lost). Protection against ventricular arrhythmias can also result from brief periods of cardiac pacing, which leads to both immediate and delayed protection, e.g., a marked reduction in the incidence of ischemia-induced ventricular fibrillation, five minutes after pacing and also 24 hours later. This delayed protection against arrhythmias is less marked 48 and 72 hours after the pacing stimulus but can be reinstated, and lasts for a more prolonged period, if dogs are repaced at a time when protection from the initial pacing stimulus begins to wane. Whether it is possible to protect the heart in the longer term by pacing is unknown but is under investigation. Although the precise mechanisms of both the early and delayed protection are not yet fully understood, there is some evidence that endogenous protective mediators derived from coronary vascular endothelium, such as bradykinin, nitric oxide, and prostanoids (most likely prostacyclin), are involved in both phases of this antiarrhythmic protection. These may then trigger the induction, during the late phase, of protective proteins.

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Authors and Affiliations

  1. Albert Szent-Györgyi Medical University, Hungary

    Agnes Vegh, Adrienn Kis & Julius Gy Papp

  2. University of Strathclyde, USA

    James R. Parratt

Authors
  1. Agnes Vegh
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  2. Adrienn Kis
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  3. Julius Gy Papp
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  4. James R. Parratt
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Editor information

Editors and Affiliations

  1. Department of Medicine Aoto Hospital, Jikei University School of Medicine, Tokyo, Japan

    Seibu Mochizuki M.D., Ph.D. (Professor and Chairman) (Professor and Chairman)

  2. Department of Internal Medicine Aoto Hospital, Jikei University School of Medicine, Tokyo, Japan

    Nobuakira Takeda M.D., Ph.D. (Associate Professor) (Associate Professor)

  3. Jikei University School of Medicine, Tokyo, Japan

    Makoto Nagano M.D., Ph.D. (Professor-Emeritus) (Professor-Emeritus)

  4. MRC Group in Experimental Cardiology Institute of Cardiovascular Sciences St. Boniface General Hospital Research Centre Faculty of Medicine, University of Manitoba, Winnipeg, Canada

    Naranjan S. Dhalla Ph.D., M.D. (Hon.), D.Sc. (Hon.) (Distinguished Professor and Director) (Distinguished Professor and Director)

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Vegh, A., Kis, A., Gy Papp, J., Parratt, J.R. (1998). Early and Delayed Protection Against Ventricular Arrhythmias Induced by Preconditioning. In: Mochizuki, S., Takeda, N., Nagano, M., Dhalla, N.S. (eds) The Ischemic Heart. Progress in Experimental Cardiology, vol 1. Springer, Boston, MA. https://doi.org/10.1007/978-0-585-39844-0_21

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