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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2000 Ottobre;41(5):675-82

lingua: Inglese

Transmyocardial laser treatment reduces ischemia-induced ventricular fibrillation during the early phase (1a) after coronary artery occlusion in open chest anesthetized pigs

Tjomsland O. 1,2, Grubd F. 2, Kanellopoulos G. K. 2, Kvernebo K. 1, Ilebekk A. 2

From the 1 Depart­ment of Car­di­o­vas­cular Sur­gery 2 Insti­tute for Experi­mental Med­ical ­Research Ulle­vaal Hos­pital Uni­ver­sity of ­Oslo, ­Norway


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Intro­duc­tion. It has pre­vi­ously ­been ­shown ­that trans­myo­car­dial revas­cu­lar­iza­tion ­with ­laser (TMR) ­prior to cor­o­nary ­artery occlu­sion ­decreases the occur­rence of ­ischemia-­induced arrhyth­mias. The aim of the ­present ­study was to deter­mine the ­effects of TMR on ven­tric­ular fib­ril­la­tion and ­other arrhyth­mias ­during the ­early (1a) and ­late ­phase (1b) of ­ischemia in ­pigs.
­Methods. In six ­pigs TMR was per­formed in the ante­rior ­wall of the ­left ven­tricle 60 min­utes ­prior to occlu­sion of the prox­imal LAD. Six ­other ­pigs ­were sub­jected to cor­o­nary occlu­sion ­without pre­ceding TMR and ­served as con­trols.
­Results. ­During the 30 min ­period ­with LAD occlu­sion ven­tric­ular fib­ril­la­tion ­occurred 22 ­times in 5 of 6 con­trol ani­mals (20 epi­sodes in ­phase 1a, 2 in ­phase 1b), ­whereas ­none of the ani­mals sub­jected to TMR ­prior to the cor­o­nary ­artery occlu­sion devel­oped ven­tric­ular fib­ril­la­tion (p<0.01). The ­total ­number of pre­ma­ture ­beats per ­animal was ­lower ­during the ­early ­phase (1a) ­after LAD occlu­sion in the TMR ­group ­than in the con­trol ­group (18±13 vs 248±82, p<0.05).
Con­clu­sions. TMR ­prior to occlu­sion of LAD ­reduced the occur­rence of ­early ­phase (la) ­ischemia-­induced ven­tric­ular fib­ril­la­tion and pre­ma­ture ­beats. ­This ­anti-fibril­la­tory ­effect ­might ­explain the ­improved sur­vival ­observed in experi­mental ­studies ­after TMR ­prior to cor­o­nary ­artery occlu­sion ­found by ­others.

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