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Supraventricular arrhythmias in experimental myocardial infarction

In vivo and in vitro correlations

Supraventrikuläre Arrhythmien bei experimentellem Myokardinfarkt

In-vivo- und In-vitro-Befunde

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Summary

The electrophysiological mechanisms underlying supraventricular dysrhythmias that accompany acute myocardial infarction were studied in rabbits subjected to ligation of right coronary artery. In vivo, sinus bradycardia, atrioventricular block and rapid atrial arrhythmias were observed 2 to 5 hours after coronary occlusion; evidence of ventricular arrhythmias was absent. The bradyarrhythmias were markedly improved after iv administration of atropine. The infarcted hearts were then removed and the isolated sinoatrial (SA) node, right atrium and atrioventricular (AV) node were studied with intracellular microelectrodes in vitro. Rapid, repetitive atrial depolarizations occurring spontaneously or initiated by premature atrial stimulation were observed only in preparations obtained from infarcted hearts. In disseminated areas localized within the SA node and the atrium, the subendocardial fibers had a reduced action potential amplitude but showed also normal potentials in other regions as compared with noninfarcted preparations. Sinus rate, poststimulatory sinus-node recovery time, intraatrial conduction and the parameters of AV nodal function including action potential amplitude and conduction were not significantly different in preparations isolated from infarcted and noninfarcted hearts. The results suggest that the observed bradyarrhythmias accompanying acute myocardial infarction may be partly due to a vagomimetic reflex whereas the supraventricular tachycardias seem to result from direct cellular damage.

Zusammenfassung

Die elektrophysiologischen Mechanismen von supraventrikulären Arrhythmien bei akutem Myokardinfarkt wurden an Kaninchen untersucht, bei denen die rechte Koronararterie unterbunden wurde. In vivo wurden 2 bis 3 Stunden nach Koronarverschluß eine Sinusbradykardie, atrioventrikuläre Blockierungen und atriale Tachykardien beobachtet. Atropin (i.v.) führte zu einer signifikanten Rückbildung der Bradykardien. Anschließend wurden die infarzierten Herzen freipräpariert und der rechte Vorhof einschließlich sinuatrialem (SA) und atrioventrikulärem (AV) Knoten mit intrazellulären Mikroelektroden in vitro untersucht. Im Vergleich zu Kontrollpräparaten von nichtinfarzierten Herzen wurden bei Vorhöfen von infarzierten Herzen folgende Befunde beobachtet:

1. Spontane atriale Tachykardien. 2. Abnahme der Amplitude des Aktionspotentials in disseminierten subendokardialen atrialen und SA nodalen Fasern, aber normale Aktionspotentiale bei der Mehrzahl der untersuchten Fasern. 3. Normale Sinusfrequenz, poststimulatorische Sinusknotenerholungszeit, intraatriale und AV nodale Leitungszeiten. Die Befunde deuten auf einen vagomimetischen Reflex als überwiegende Ursache der in vivo beobachteten Bradykardien hin, während die supraventrikulären Tachykardien möglicherweise durch eine direkte Schädigung der Zellmembran bedingt sind.

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Author notes

  1. J. Senges M. D.

    Present address: Abteilung Innere Medizin III (Kardiologie), Medizinische Universitätsklinik und Anatomisches Institut, Bergheimer Str. 58, 6900, Heidelberg, Germany

Authors and Affiliations

  1. Abteilung Innere Medizin III (Kardiologie), Medizinische Universitätsklinik und Anatomisches Institut, Bergheimer Str. 58, 6900, Heidelberg, Germany

    T. Mizutani, J. Brachmann, E. Hennig, D. Pelzer, E. Weihe & W. Kübler

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  1. T. Mizutani
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  2. J. Senges M. D.
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  3. J. Brachmann
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  4. E. Hennig
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  5. D. Pelzer
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  6. E. Weihe
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  7. W. Kübler
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Additional information

With 8 figures and 2 tables

The studies were supported by the German Research Foundation within the SFB 90 “Cardiovaskuläres System”. Dr.Mizutani is a Research Fellow of the Alexander von Humboldt Stiftung.

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Mizutani, T., Senges, J., Brachmann, J. et al. Supraventricular arrhythmias in experimental myocardial infarction. Basic Res Cardiol 74, 83–94 (1979). https://doi.org/10.1007/BF01907687

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  • DOI: https://doi.org/10.1007/BF01907687

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