Transmural reentry during acute global ischemia and reperfusion in canine ventricular muscle

Jiashin Wu, Douglas P. Zipes

Research output: Contribution to journalArticle

45 Scopus citations

Abstract

Coronary occlusion and reperfusion produce tachyarrhythmias. We tested the hypothesis that variations in transmural activation after global ischemia and reperfusion were responsible for arrhythmias. We arterially perfused 36 isolated transmural wedges from canine left ventricular free walls. After ≥100 min of stabilization, the artery was occluded for 25 min, followed by reperfusion at various flow rates. We recorded 256 channels of fluorescent action potentials on transmural surfaces from preocclusion to > 15 min after reperfusion. During endocardial pacing at 300 ms, ischemia of ≥570 ± 165 s (n = 34) produced 1:1 endocardial conduction and then 2:1 and 4:1 block as the wave fronts conducted toward epicardium. Transmural reentry appeared after 535 ± 146 s of ischemia (n = 31). Further ischemia caused epicardial inactivation and eliminated reentry (n = 24). During reperfusion, tissues progressed through sequences of epicardial inactivation and reappearance of activation with 1:1, 2:1, and 4:1 conduction; both sustained and nonsustained reentry occurred. We conclude that heterogeneous activation responses to endocardial pacing during acute ischemia provide the substrate for initiating reentry, suppressed reentry during further ischemia, and caused reentry during reperfusion.

Original languageEnglish (US)
Pages (from-to)H2717-H2725
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume280
Issue number6 49-6
DOIs
StatePublished - 2001

Keywords

  • Arterial occlusion
  • Fibrillation
  • Heart
  • Optical mapping
  • Tachyarrhythmias

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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