Mechanical triggers and facilitators of ventricular tachy-arrhythmias

Quinn, T. Alexander; Kohl, Peter

doi:10.1093/med/9780199570164.003.0022

Cited by 9 publications

(7 citation statements)

References 35 publications

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“…54–56 Perturbations of the heart's mechanical status can occur as a consequence of intrinsic and extrinsic stimuli. Intrinsic stimuli include, among others, alterations in preload (discussed above in the context of pacemaker activity), and in intra-cardiac stress–strain distribution (discussed below in the context of whole-heart mechano-electric function).…”

Section: Wet/dry Integration: From Micro To Macromentioning

confidence: 99%

Combining wet and dry research: experience with model development for cardiac mechano-electric structure-function studies

Quinn

Kohl

2013

Cardiovascular Research

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Since the development of the first mathematical cardiac cell model 50 years ago, computational modelling has become an increasingly powerful tool for the analysis of data and for the integration of information related to complex cardiac behaviour. Current models build on decades of iteration between experiment and theory, representing a collective understanding of cardiac function. All models, whether computational, experimental, or conceptual, are simplified representations of reality and, like tools in a toolbox, suitable for specific applications. Their range of applicability can be explored (and expanded) by iterative combination of ‘wet’ and ‘dry’ investigation, where experimental or clinical data are used to first build and then validate computational models (allowing integration of previous findings, quantitative assessment of conceptual models, and projection across relevant spatial and temporal scales), while computational simulations are utilized for plausibility assessment, hypotheses-generation, and prediction (thereby defining further experimental research targets). When implemented effectively, this combined wet/dry research approach can support the development of a more complete and cohesive understanding of integrated biological function. This review illustrates the utility of such an approach, based on recent examples of multi-scale studies of cardiac structure and mechano-electric function.

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Section: Wet/dry Integration: From Micro To Macromentioning

confidence: 99%

Combining wet and dry research: experience with model development for cardiac mechano-electric structure-function studies

Quinn

Kohl

2013

Cardiovascular Research

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“…Mechanoelectric coupling (MEC) is thought to be the underlying mechanism whereby VF is easily induced with mechanical stimulation. One of the major factors in the mechanism of MEC are mechanosensitive ion channels that are activated in response to an extrinsic stimulus (such as cardiac catheterization), extracorporeal impacts, or precordial thump application 7 . These mechanosensitive ion channels include stretch-activated cations and cell volume–activated channels 7 .…”

Section: Discussionmentioning

confidence: 99%

“…One of the major factors in the mechanism of MEC are mechanosensitive ion channels that are activated in response to an extrinsic stimulus (such as cardiac catheterization), extracorporeal impacts, or precordial thump application 7 . These mechanosensitive ion channels include stretch-activated cations and cell volume–activated channels 7 . Nonselective stretch-activated cations and potassium-selective stretch-activated cations are thought to be responsible for mechanical action potential induction 7 .…”

Section: Discussionmentioning

confidence: 99%

“…These mechanosensitive ion channels include stretch-activated cations and cell volume–activated channels 7 . Nonselective stretch-activated cations and potassium-selective stretch-activated cations are thought to be responsible for mechanical action potential induction 7 . The additional activation of potassium-selective stretch-activated cations is also likely to form one of the mechanisms that help sustain tachyarrhythmic responses 7 …”

Section: Discussionmentioning

confidence: 99%

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Use of topical lidocaine in eliminating mechanically stimulated ventricular fibrillation in a patient with short QT syndrome

Farag

Atallah

2019

HeartRhythm Case Reports

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“…Prolonged altered stretch has been shown to cause changes in repolarizing membrane currents (Jeyaraj and Rosenbaum, 2011 ). The effect of pulsatile myocardial stretch on repolarization depends on the timing relative to the repolarization process (Reiter et al, 1988 ; Zabel et al, 1996 ; Quinn and Kohl, 2011 ). For example, stretch modulates APD through cation non-selective (SACns) and potassium selective stretch activated channels (SACk).…”

Section: Discussionmentioning

confidence: 99%

The Association of Abnormal Ventricular Wall Motion and Increased Dispersion of Repolarization in Humans is Independent of the Presence of Myocardial Infarction

Opthof¹,

Sutton²,

Coronel³

et al. 2012

Front. Physio.

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Abnormal ventricular wall motion is a strong clinical predictor of sudden, arrhythmic, cardiac death. Dispersion in repolarization is a prerequisite for the initiation of re-entrant arrhythmia. We hypothesize that regionally decreased wall motion is associated with heterogeneity of repolarization. We measured local activation times, activation-recovery intervals (ARIs, surrogate for action potential duration), and repolarization times using a multielectrode grid at nine segments on the left ventricular epicardium in 23 patients undergoing coronary artery surgery. Regional wall motion was simultaneously assessed using intraoperative transesophageal echocardiography. Three groups were discriminated: (1) Patients with normal wall motion (n = 11), (2) Patients with one or more hypokinetic segments (n = 6), (3) Patients with one or more akinetic or dyskinetic segments (n = 6). The average ARI was similar in all groups (251 ± 3.7 ms, ±SEM). Dispersion of ARIs between the nine segments was significantly increased in the hypokinetic (84 ± 7.4 ms, p < 0.005) and akinetic/dyskinetic group (94 ± 3.5 ms, p < 0.0005) compared with the normal group (49 ± 5.1 ms), independent from the presence of myocardial infarction. Repolarization heterogeneity occurred primarily in the normally contracting regions of the hearts with abnormal wall motion. An almost maximal increased dispersion of repolarization was observed when there was only a single hypokinetic segment. We conclude that inhomogeneous wall motion abnormality of even moderate severity is associated with increased repolarization inhomogeneity, independent from the presence of infarction.

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Mechanical triggers and facilitators of ventricular tachy-arrhythmias

Cited by 9 publications

References 35 publications

Combining wet and dry research: experience with model development for cardiac mechano-electric structure-function studies

Combining wet and dry research: experience with model development for cardiac mechano-electric structure-function studies

Use of topical lidocaine in eliminating mechanically stimulated ventricular fibrillation in a patient with short QT syndrome

The Association of Abnormal Ventricular Wall Motion and Increased Dispersion of Repolarization in Humans is Independent of the Presence of Myocardial Infarction

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