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Autonomic nervous system, myocardial ischemia, and malignant ventricular arrhythmias: Experimental findings

  • Chapter
Myocardial Ischemia and Arrhythmia

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Summary

Acute myocardial ischemia elicits both sympathetic and vagal reflexes. Dominant sympathetic reflexes cause an increase in heart rate, myocardial oxygen consumption and a decrease in cardiac electrical stability, thus facilitating the occurrence of malignant arrhythmias. On the other hand, recent evidence from experimental studies suggests that increased vagal activity during acute myocardial ischemia decreases the likelihood of ventricular fibrillation. In a conscious animal model of sudden cardiac death, indexes of reduced vagal tone and of impaired vagal reflexes identify dogs at higher risk for ventricular fibrillation during acute myocardial ischemia.

A further direct indication that vagal activity is indeed beneficial during myocardial ischemia derives from studies involving either neural recording of vagal activity or an interaction with the parasympathetic nervous system. The latter were achieved either electrically, by the stimulation of the vagus, or pharmacologically by muscarinic agonists and antagonists.

These experimental studies indicate that: 1) indexes of vagal tone and reflexes may help to identify subjects at higher risk for sudden cardiac death; 2) interference with the autonomic nervous system causing a shift toward a vagal dominance may represent a new strategy in the prevention of sudden cardiac death.

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Authors and Affiliations

  1. Istituto di Clinica Medica Generale e Terapia Medica Universita’ degli Studi di Milano, Centro di Fisiologia Clinica e Ipertensione, Milano, Italy

    G. M. De Ferrari & P. J. Schwartz MD (Professor of Medicine)

  2. Divisione di Cardiologia, Ospedale Maggiore Policlinico IRCCS Milano, Italy

    G. M. De Ferrari

  3. Dipartimento di Medicina, Universita’ degli Studi Pavia, Pavia, Italy

    P. J. Schwartz MD (Professor of Medicine)

  4. Istituto di Clinica Medica Generale e Terapia Medica, University of Milano, Via F. Sforza, 35, 20122, Milano, Italy

    P. J. Schwartz MD (Professor of Medicine)

Authors
  1. G. M. De Ferrari
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  1. Abt. Innere Medizin III, Medizinische Universitätsklinik, Hugstetter Straße 55, 79106, Freiburg, Germany

    M. Zehender  & H. Just  & 

  2. Innere Medizin, Universitätskrankenhaus Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    T. Meinertz

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© 1994 Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt

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De Ferrari, G.M., Schwartz, P.J. (1994). Autonomic nervous system, myocardial ischemia, and malignant ventricular arrhythmias: Experimental findings. In: Zehender, M., Meinertz, T., Just, H. (eds) Myocardial Ischemia and Arrhythmia. Steinkopff. https://doi.org/10.1007/978-3-642-72505-0_16

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  • DOI: https://doi.org/10.1007/978-3-642-72505-0_16

  • Publisher Name: Steinkopff

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