Mild hypothermia decreases arrhythmia susceptibility in a canine model of global myocardial ischemia*

Q: What is the clinical evidence from this study?

Population: Global myocardial ischemia (n=13). Intervention: Mild hypothermia vs. Control (36°C). Primary outcome: Epicardial conduction block.

Joseph S. Piktel; David Rosenbaum; Lance D. Wilson

doi:10.1097/ccm.0b013e31825fd39d

August 13, 2012Critical Care MedicineOpen Access

Mild hypothermia decreases arrhythmia susceptibility in a canine model of global myocardial ischemia*

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Key result

Mild hypothermia prevented epicardial conduction block (0% vs 85.7%) and attenuated ischemia-induced conduction slowing and dispersion of repolarization in a canine model of global ischemia.

Why the study?

Does mild hypothermia decrease arrhythmia susceptibility (dispersion of repolarization and conduction slowing) in a canine model of global myocardial ischemia?

Key Points

The study aims to investigate the effects of mild hypothermia on arrhythmia susceptibility during global myocardial ischemia.
Developed a canine model of global ischemia using left ventricle wedge preparations.
Examined two temperature conditions: control at 36°C and mild hypothermia at 32°C during 15 minutes of ischemia.
Measured optical action potentials and assessed conduction velocity and dispersion of repolarization during ischemia and reperfusion.
In control, conduction velocity decreased significantly from 0.46 ± 0.02 m/sec to 0.23 ± 0.07 m/sec during ischemia (p < .001).
Mild hypothermia slowed conduction velocity decrease to 0.35 ± 0.03 m/sec (p = .019) and reduced dispersion increase from 25 ± 3 msecs to 37 ± 7 msecs (p = .037).
No conduction block was observed in the mild hypothermia group compared to six of seven preparations in the control group.

Structured PICO

Does mild hypothermia decrease arrhythmia susceptibility (dispersion of repolarization and conduction slowing) in a canine model of global myocardial ischemia?

P

Population

13 male mongrel dog left ventricle wedge preparations subjected to 15 minutes of no-flow ischemia and reperfusion.

I

Intervention

Mild hypothermia (32°C) induced prior to 15 mins of no-flow ischemia and subsequent reperfusion

C

Comparator

Control temperature (36°C) prior to 15 mins of no-flow ischemia and subsequent reperfusion

O

Outcome

Transmural dispersion of repolarization and conduction velocity during ischemia and reperfusionsurrogate

Main Result

Absolute Event Rate: 0% vs 85.7%

Mild hypothermia attenuates ischemia-induced conduction slowing and dispersion of repolarization in a canine model, suggesting a mechanism by which therapeutic hypothermia may decrease arrhythmogenesis during myocardial ischemia.

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Implication

Hypothesis-generating for antiarrhythmic effects in ischemia; leaves open clinical translation of mild hypothermia.

Abstract

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Cite This Study

Piktel et al. (2012) studied Global myocardial ischemia (n=13). Mild hypothermia vs. Control (36°C) was evaluated on Epicardial conduction block. Mild hypothermia prevented epicardial conduction block (0% vs 85.7%) and attenuated ischemia-induced conduction slowing and dispersion of repolarization in a canine model of global ischemia.

synapsesocial.com/papers/6a2215c662598c6ccd4927c7 https://doi.org/10.1097/ccm.0b013e31825fd39d

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Mild hypothermia decreases arrhythmia susceptibility in a canine model of global myocardial ischemia*

Key Points

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Mild hypothermia decreases arrhythmia susceptibility in a canine model of global myocardial ischemia*

Key Points

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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