Key result
Large animal AMI models clarify VF mechanisms and pharmacological interventions despite clinical translation challenges.
Why the study?
Studying spontaneous VF following AMI in humans is challenging because it often occurs unexpectedly, making large animal models necessary to investigate arrhythmia mechanisms and therapeutic options.
Large animal models provide valuable translational insights into the pathophysiology and arrhythmogenic mechanisms of first acute myocardial infarction, aiding in the discovery of novel acute antiarrhythmic treatments.
Should not yet change clinical practice; leaves open whether large animal insights will yield effective antiarrhythmic therapies.
Ventricular arrhythmia and subsequent sudden cardiac death (SCD) due to acute myocardial infarction (AMI) is one of the most frequent causes of death in humans. Lethal ventricular arrhythmias like ventricular fibrillation (VF) prior to hospitalization have been reported to occur in more than 10% of all AMI cases and survival in these patients is poor. Identification of risk factors and mechanisms for VF following AMI as well as implementing new risk stratification models and therapeutic approaches is therefore an important step to reduce mortality in people with high cardiovascular risk. Studying spontaneous VF following AMI in humans is challenging as it often occurs unexpectedly in a low risk subgroup. Large animal models of AMI can help to bridge this knowledge gap and are utilized to investigate occurrence of arrhythmias, involved mechanisms and therapeutic options. Comparable anatomy and physiology allow for this translational approach. Through experimental focus, using state-of-the-art technologies, including refined electrical mapping equipment and novel pharmacological investigations, valuable insights into arrhythmia mechanisms and possible interventions for arrhythmia-induced SCD during the early phase of AMI are now beginning to emerge. This review describes large experimental animal models of AMI with focus on first AMI-associated ventricular arrhythmias. In this context, epidemiology of first AMI, arrhythmogenic mechanisms and various potential therapeutic pharmacological targets will be discussed.
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Sattler et al. (2019) conducted a review in Acute Myocardial Infarction and Ventricular Fibrillation. Large animal models of acute myocardial infarction provide valuable insights into the mechanisms of ventricular fibrillation and potential pharmacological interventions, though translation to clinical trials remains challenging.
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