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Arrhythmias and the Healed Myocardial Infarction

  • Chapter
Lethal Arrhythmias Resulting from Myocardial Ischemia and Infarction

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 94))

Abstract

The major hypothesis guiding our studies of arrhythmias in experimental healed myocardial infarction is that during the evolution and subsequent healing of experimental myocardial infarction, some tissues exposed to ischemic injury heal, but persisting abnormalities in the healed tissues influence the characteristics of electrophysiologic responses to future events. A subordinate premise is that mechanisms for electrophysiologic disturbances in hearts with healed myocardial infarction extend beyond the structural and geometric abnormalities created by the presence of a scar with surrounding or intertwining bands of muscle. There are data demonstrating that long-term changes in patterns of repolarization and response to antiarrhythmic agents may result from either uncoupling or long-term changes in membrane properties; that persistent changes in adrenergic receptors and the adenylate cyclase-cyclic AMP axis are present in hearts with healed infarction; and that neurophysiologic abnormalities may result from nerve damage, membrane responses to sympathetic stimulation, or both. AH of these changes are quantitatively and/or qualitatively regional in distribution. The consequence of regional alterations in properties of hearts with healed infarction becomes most obvious during subsequent acute ischemia and may explain, in part, why the heart with healed myocardial infarction is more susceptible to potentially lethal arrhythmias.

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References

  1. Myerburg, R.J., Zaman, L., Luceri, R., et al. 1983. Antiarrhythmic drug therapy after myocardial infarction. The First Year After a Myocardial Infarction, in H.E. Kulbertus and H.J.J. eds. Wellens, pp. 321–339, Mt. Kisco, NY, Futura Publishing Co.

    Google Scholar 

  2. The CAPS Investigators. 1986. The cardiac arrhythmia pilot study. Am. J. Cardiol. 57:91–95.

    Article  Google Scholar 

  3. Ruberman, W., Weinblatt, E., Frank, C.W. et al. 1981. Repeated 1 hour electrocardiographic monitoring of survivors of myocardial infarction at 6 month intervals: arrhythmia detection and relation to prognosis. Am. J. Cardiol. 47:1197–1204.

    Article  PubMed  CAS  Google Scholar 

  4. Wellens, H.J.J., Bär, F.W.H.M., Vanagt, E.J.D.M., and Brugada, P. 1982. Medical treatment of ventricular tachycardia: Considerations in the selection of patients for surgical treatment. Am. J. Cardiol. 49:186–193.

    Article  PubMed  CAS  Google Scholar 

  5. Lie, K.L., Liem, K.L., Schuilenberg, R.M. et al. 1978. Early identification of patients developing late in-hospital ventricular fibrillation after discharge from the coronary care unit. Am. J. Cardiol. 41:674–677.

    Article  PubMed  CAS  Google Scholar 

  6. Myerburg, R.J. and Castellanos, A. 1988. Cardiac arrest and sudden cardiac death. In Heart Disease: A Textbook of Cardiovascular Medicine, E. Braunwald ed., pp. 742–747, 3rd Ed. Philadelphia, WB Saunders Co.

    Google Scholar 

  7. Myerburg, R.J., Kessler, K.M., Zaman, L., et al. 1987. Factors leading to decreasing mortality among patients resuscitated from out-of-hospital cardiac arrest, in Cardiac Arrhythmias: Where Do We Go From Here? P. Brugada and H.J.J. Wellens eds., pp. 505–525, Mt. Kisco, NY., Futura Publishing Co.

    Google Scholar 

  8. Myerburg, R.J., Kessler, K.M., Estes, D., et al. 1984. Long-term survival after prehospital cardiac arrest: analysis of outcome during an 8-year study. Circulation 70:538–546.

    Article  PubMed  CAS  Google Scholar 

  9. Myerburg, R.J., Gelband, H., Nilsson, K., et al. 1977. Long-term electrophsiologic abnormalities resulting from experimental myocardial infarction in cats. Cir. Res. 41:73–84.

    CAS  Google Scholar 

  10. Myerburg, R.J., Epstein, K., Gaide, M.S., et al. 1982. Cellular electrophysiology in acute and healed experimental myocardial infarction. Ann. NY Acad. Sci. 382:90–115.

    Article  PubMed  CAS  Google Scholar 

  11. Kozlovskis, P.L., Fieber, L.A., Bassett, A.L., et al. 1986. Regional reduction in ventricular norepinephrine after healing of experimental myocardial infarction in cats. J. Mol. Cell. Cardiol. 18:413–422.

    Article  PubMed  CAS  Google Scholar 

  12. Myerburg, R.J., Bassett, A.L., Epstein, K., et al. 1982. Electrophysiologic effects of procainamide in acute and healed experimental ischemic injury of cat myocardium. Circ. Res, 50:386–393.

    PubMed  CAS  Google Scholar 

  13. Myerburg, R.J., Epstein, K., Gaide, M.S., et al. 1982. Electrophysiologic consequences of experimental acute ischemia superimposed upon healed myocardial infarction in cats. Am. J. Cardiol. 49:323–330.

    Article  PubMed  CAS  Google Scholar 

  14. Michelson, E.L., Spear, J.F., and Moore, E.N. 1980. Electrophysiologic and anatomic correlates of sustained ventricular tachyarrhythmias in a model of chronic myocardial infarction. Am. J. Cardiol. 45:583–590.

    Article  PubMed  CAS  Google Scholar 

  15. Wong, S.S., Bassett, A.L., Cameron, J.S., et al. 1982. Dissimilarities in the electrophysiological abnormalities of lateral border and central infarct zone cells after healing of myocardial infarction in cats. Circ. Res. 51:486–493.

    PubMed  CAS  Google Scholar 

  16. Wong, S.S., Myerburg, R.J., Cameron, J.S., et al. 1982. Electrophysiologic effects of verapamil on cells bordering healed myocardial infarction in the cat. Proc. Soc. Exper. Bid. Med. 171:289–293.

    CAS  Google Scholar 

  17. Kimura, S., Bassett, A.L., Gaide M.S., et al. 1986. Regional changes in intracellular potassium and sodium activity after healing of experimental myocardial infarction in cats. Circ. Res. 58:202–208.

    PubMed  CAS  Google Scholar 

  18. Gaide, M.S., Myerburg, R.J., Kozlovskis, P.L., and Bassett, A.L. 1983. Elevated sympathetic response of epicardium proximal to healed myocardial infarction. Am. J. Physiol. 14:646–652.

    Google Scholar 

  19. Barber, M.J., Mueller, T.M., Henry, D.P., et al. 1982. Transmural myocardial infarction in the dog produces sympathectomy in non-infarcted myocardium. Circulation 67:787–796.

    Article  Google Scholar 

  20. Kammerling, J.J., Green, F.J., Watanabe, A.M., et al. 1987. Denervation supersensitivity of refractoriness in noninfarcted areas apical to transmural myocardial infarction. Circulation 76:383–393.

    Article  PubMed  CAS  Google Scholar 

  21. Kozlovskis, P.L., Smets, M.J.D., Bassett, A.L., et al. 1988. Regional beta-adrenergic receptors and adenylate cyclase activity after healing of myocardial infarction in cats, (abstr.) J. Amer. Coll. Card. 11:252.

    Article  Google Scholar 

  22. Kimura, S., Bassett, A.L., Kohya, T., et al. 1987. Automaticity, triggered activity, and responses to adrenergic stimulation in cat subendocardial Purkinje fibers after healing of myocardial infarction. Circulation 75:651–660.

    Article  PubMed  CAS  Google Scholar 

  23. Kimura, S., Cameron, J.S., Kozlovskis, P.L., et al. 1984. Delayed afterdepolarizations and triggered activity induced in feline Purkinje fibers by alpha-adrenergic stimulation in the presence of elevated calcium levels. Circulation 70:1074–1082.

    Article  PubMed  CAS  Google Scholar 

  24. Kimura, S., Bassett, A.L., Saoudi, N.C., et al. 1986. Cellular electrophysiologic changes and “Arrhythmias” during experimental ischemia and reperfusion in isolated cat ventricular myocardium. J. Am. Coll. Cardiol. 7:833–842.

    Article  PubMed  CAS  Google Scholar 

  25. Kimura, S., Bassett, A.L., Kohya, T., et al. 1986. Simultaneous recording of action potentials from endocardium and epicardium during ischemia in the isolated cat ventricle: relation of temporal electrophysiological heterogeneities to arrhythmias. Circulation 74:401–409.

    Article  PubMed  CAS  Google Scholar 

  26. Kimura, S., Bassett, A.L., Kohya, T., et al. 1987. Regional effects of verapamil on recovery of excitability and conduction time in experimental ischemia. Circulation 76:1146–1154.

    Article  PubMed  CAS  Google Scholar 

  27. Kimura, S., Bassett, A.L., Kozlovskis, P.L., and Myerburg, R.J. 1987. Electrophysiologic changes during acute ischemia in coronary perfused cat ventricle with healed myocardial infarction (HMI). Circulation 76 (Suppl. IV):109.

    Google Scholar 

  28. Corr, R.B., Gross, R.W., and Sobel, B.E. 1984. Amphipathic metabolites and membrane dysfunction in ischemic myocardium. Circ. Res. 55:135–154.

    PubMed  CAS  Google Scholar 

  29. Manning, A.S., Coltart, D.J. and Hearse, D.J. 1984. Ischemia and reperfusion-induced arrhythmias in the rat: Effect of xanthine oxides inhibition with allopurinol. Circ. Res. 55:544–548.

    Google Scholar 

  30. Pogwizd, S.M. and Corr, P.B. 1987. Electrophysiologic mechanisms underlying arrhythmias due to reperfusion of ischemic myocardium. Circulation 76:404–426.

    Article  PubMed  CAS  Google Scholar 

  31. Pogwizd, S.M. and Corr, P.B. 1987. Reentrant and nonreentrant mechanisms contribute to arrhythmogenesis during early myocardial ischemia: results using three-dimensional mapping. Circ. Res. 61:352–371.

    PubMed  CAS  Google Scholar 

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Authors
  1. Robert J. Myerburg
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  2. Shinichi Kimura
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  3. Patricia L. Kozlovskis
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  4. Arthur L. Bassett
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  5. Heikki Huikuri
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  6. Agustin Castellanos
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Editor information

Editors and Affiliations

  1. Department of Pharmacology, Columbia University College of Physicians and Surgeons, 630 West 168th Street, P&S 7-517, New York, 10032, New York, USA

    Michael R. Rosen M.D. (Professor of Pharmacology and Pediatrics) (Professor of Pharmacology and Pediatrics)

  2. Rappaport Family Institute for Research in the Medical Sciences, Technion-Israel Institute of Technology, Efron Street, Post Office Box 9697, Haifa, 31096, Israel

    Yoram Palti M.D., Ph.D. (Director) (Director)

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© 1989 Kluwer Academic Publishers, Boston/Dordrecht/London

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Myerburg, R.J., Kimura, S., Kozlovskis, P.L., Bassett, A.L., Huikuri, H., Castellanos, A. (1989). Arrhythmias and the Healed Myocardial Infarction. In: Rosen, M.R., Palti, Y. (eds) Lethal Arrhythmias Resulting from Myocardial Ischemia and Infarction. Developments in Cardiovascular Medicine, vol 94. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1649-7_17

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  • DOI: https://doi.org/10.1007/978-1-4613-1649-7_17

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8916-6

  • Online ISBN: 978-1-4613-1649-7

  • eBook Packages: Springer Book Archive

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