Cocaine-enhanced arrhythmogenesis: neural and nonneural mechanisms

1992 ◽  
Vol 70 (2) ◽  
pp. 240-246 ◽  
Author(s):  
Nicholas S. Gantenberg ◽  
Gilbert R. Hageman
Keyword(s):  
Electrical Stimulation ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Cardiovascular Complications ◽  
Programmed Electrical Stimulation ◽  
Calcium Channel Blockade ◽  
Adrenergic Mechanism ◽  
Cocaine Infusion ◽  
Stimulation Of

Cocaine abuse increases the susceptibility to cardiovascular complications and sudden cardiac death in man. We used programmed electrical stimulation of the heart to examine the arrhythmogenic influence of cocaine. Twenty-three pentobarbital-anesthetized adult dogs underwent programmed electrical stimulation using one to four extrastimuli before and during cocaine infusion. Autonomic decentralization was performed prior to the protocol in eight dogs. Induced ventricular arrhythmias included single premature ventricular depolarizations, doublets, triplets, ventricular tachycardia, and ventricular fibrillation. Intravenous cocaine, and subsequent adrenergic and muscarinic receptor blockade, or calcium channel blockade were evaluated for their influence on arrhythmogenesis. The incidence of induced ventricular arrhythmias was significantly elevated following cocaine and was reduced following propranolol and atropine. Verapamil, however, did not reduce the incidence of induced arrhythmias. In addition, cocaine significantly increased arrhythmia induction in decentralized animals, but propranolol, atropine, and phentolamine failed to reduce the proarrhythmic effects of cocaine in these animals. Thus, cocaine has a proarrhythmic effect on the heart with multiple mechanisms. The adrenergic mechanism appears to be a result of neurotransmitter uptake blockade, whereas the likely ionic mechanism is a neurally independent, direct effect on the heart.Key words: cocaine, programmed electrical stimulation, ventricular arrhythmias, sympathetic nervous system, sudden cardiac death.

scholarly journals Long-term subthreshold electrical stimulation of the left stellate ganglion and a canine model of sudden cardiac death

2004 ◽  
Vol 43 (5) ◽  
pp. 858-864 ◽  
Author(s):  
Moshe Swissa ◽  
Shengmei Zhou ◽  
Ignacio Gonzalez-Gomez ◽  
Che-Ming Chang ◽  
Angela C. Lai ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Stellate Ganglion ◽  
Canine Model ◽  
Left Stellate Ganglion ◽  
Stimulation Of

scholarly journals Chronic subthreshold electrical stimulation of the left stellate ganglion and a canine model of sudden cardiac death

2003 ◽  
Vol 41 (6) ◽  
pp. 112
Author(s):  
Moshe Swissa ◽  
Shengmei Zhou ◽  
Che-Ming Chang ◽  
Adam W. Cates ◽  
Michael C. Fishbein ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Stellate Ganglion ◽  
Canine Model ◽  
Left Stellate Ganglion ◽  
Stimulation Of

RESEARCH THE VALUE OF THE COMBINATION OF T WAVE ALTERNANS AND NT-PROBNT IN PREDICTING SUDDEN CARDIAC DEATH

2012 ◽  
pp. 74-83
Author(s):  
Anh Tien Hoang ◽  
Nhat Quang Nguyen
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Healthy Person ◽  
Treadmill Test ◽  
T Wave ◽  
T Wave Alternans

Background: Decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-to-bedside foundation makes TWA, NT-ProBNP a very plausible index of susceptibility to ventricular arrythmia, and motivates the need to define optimal combination of TWA and NT-ProBNP in predicting ventricular arrythmia in myocardial infarction patients. We research this study with 2 targets: 1. To evaluate the role of TWA in predicting sudden cardiac death in myocardial infarction patients. 2. To evaluate the role of NT-ProBNP in predicting sudden cardiac death in myocardial infarction patients 3. Evaluate the role of the combined NT-ProBNP and TWA in predicting sudden cardiac death in myocardial infarction patients. Methods: Prospective study with follow up the mortality in 2 years: 71 chronic myocardial infarction patients admitted to hospital from 5/2009 to 5/20011 and 50 healthy person was done treadmill test to caculate TWA; ECG, echocardiography, NT-ProBNP. Results: Cut-off point of NT-ProBNP in predicting sudden cardiac death is 3168 pg/ml; AUC = 0,86 (95% CI: 0,72 - 0,91); Cut-off point of TWA in predicting sudden cardiac death is 107 µV; AUC = 0,81 (95% CI: 0,69 - 0,87); NT-ProBNP can predict sudden cardiac death with OR= 7,26 (p<0,01); TWA can predict sudden cardiac death with OR= 8,45 (p<0,01). The combined NT-ProBNP and TWA in predicting ventricular arrythmia in heart failure patients: OR= 17,91 (p<0,001). Conclusions: The combined NT-ProBNP and TWA have the best predict value of sudden cardiac death in myocardial infarction patients, compare to NT-ProBNP or TWA alone

Arrhythmias in dialysis patients

2021 ◽  
Vol 4 (57) ◽  
pp. 8-11
Author(s):  
Szymon Warwas ◽  
Marta Jagosz ◽  
Beata Średniawa ◽  
Michał Mazurek ◽  
Ewa Jędrzejczyk-Patej
Keyword(s):  
Cardiovascular Diseases ◽  
Sudden Cardiac Death ◽  
Kidney Disease ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Dialysis Patients ◽  
End Stage Kidney Disease ◽  
Common Cause ◽  
Conduction Disturbances ◽  
End Stage

The most common cause of death among dialysis patients with end-stage kidney disease are cardiovascular diseases. It is estimated that 18-27% of all deaths in dialysis patients are sudden cardiac deaths due to arrhythmias and conduction disturbances. The most common arrhythmias in dialysis patients, often leading to sudden death, are not ventricular arrhythmias but bradyarrhythmias. The article below discusses the most common arrhythmias in dialysis patients and methods of preventing sudden cardiac death in this group of patients.

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